CLINICAL EVALUATION OF GINGIVAL ATTACHMENT LOSS AFTER ABSOLUTE ISOLATION IN ENDODONTICS: LITERATURE REVIEW

Resumo

Objective: In this context, this study aims to evaluate, through a literature review, the relationship between the loss of gingival attachment in healthy individuals and the use of endodontic clamps during endodontic treatment. Aspects related to the pathophysiology of gingival changes, the impact of absolute isolation, and clinical strategies to minimize possible periodontal damage will be discussed. Methodology: This narrative literature review article used Rother's (2007) work as a basis, as it explains what is necessary to compose a narrative review. Thus, it was necessary to use narrative, systematic and integrative literature review articles to acquire relevant data related to the topic and with a scientific basis. Thus, to obtain this information to compose the article, searches were made in the following databases: PROSPERO; VHL/BIREME; Web of Science; PUBMED Central; The Cochrane Library; Scielo. Results: Absolute isolation in endodontics ensures a contamination-free field but may impact periodontal tissues. Clamps exert pressure, potentially causing ischemia, inflammation, and gingival attachment loss. Effects vary by clamp type, tooth location, and gingival phenotype. Further studies should refine clinical protocols. Conclusion: Absolute isolation is an indispensable tool for endodontics, ensuring a dry and contamination-free operative field, which improves treatment predictability. However, its impact on the marginal gingiva needs to be better understood and managed to avoid periodontal complications. The use of clamps can generate excessive pressure on the gingival tissues, leading to ischemia, inflammation, and, in extreme cases, irreversible loss of gingival attachment.