Análise histológica de paciente com erupção passiva alterada 1B: relato de caso

Abstract

Altered Passive Eruption (APE) is a developmental disorder that causes partial coverage of clinical crowns by periodontal tissues, which makes them short and increases the amount of visible gingiva during smiling. The height of periodontal soft and hard tissues determines the classification of APE. Type 1 and subtype B, which is the most common, is characterized by a wide range of attached gingiva and a short distance between the cementoenamel junction and the bone crest. The objective of this study was to describe a case of APE 1B and analyze its gingival histological appearance. This clinical case occurred in a 29-year-old female patient who sought care complaining that the clinical crowns were short. The diagnosis was made based on clinical and tomographic examinations, and treatment included surgery with gingivoplasty, osteotomy, and osteoplasty in the vestibular area between teeth #13 and 23. Initially, local anesthesia was administered, followed by an internal bevel incision in the vestibular area between teeth #13 and 23 and then by an intrasulcular incision between teeth #14 and 24. Six fragments of gingival collar were removed from the vestibular area of the teeth #13 to 23 and stored in a 10% buffered formalin solution for fixation. The tissues were dehydrated in baths with increasing concentrations of alcohol, embedded in baths with increasing concentrations of paraffin, and stained with hematoxylin and eosin. Histological images revealed the presence of chronic inflammation, with lymphoplasmacytic infiltrate, as well as foci of calcification. The post-surgery repair process was uneventful, and the patient reported being satisfied with the clinical appearance after 15 days of follow-up. In conclusion, in the clinical case described, no acute inflammatory manifestations were detected, only a chronic process. The evidence found suggests that, in the present condition, there are stimuli for such processes to be triggered and maintained in the gingival tissue, in addition to having found foci of calcification, which require further studies to identify their origin.