Aesthetic management of gingival recession by root biomodification with carbon dioxide laser and subepithelial connective tissue graft with lateral repositioned flap technique

The Gingival recession is considered a multi-factorial. The etiology may be an anatomically vulnerable area, faulty tooth brushing, high frenum attachment. In cases where there is progressive recession, aesthetics concern or increasing dentinal hypersensitivity, we can do recession coverage. Depending upon the presence or absence of adequate keratinized tissue we can choose the technique. In case of adequate width of keratinized tissue, usually we can do displaced flap and in case where there is inadequate width, we can do gingival grafting.

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ROOT COVERAGE USING THE SUBEPITHELIAL CONNECTIVE TISSUE GRAFT OR THE ACELLULAR DERMAL MATRIX FOR THE TREATMENT OF GINGIVAL RECESSION: A CLINICAL STUDY

International Journal of Applied Pharmaceutics ◽

10.22159/ijap.2017.v9s2.06 ◽

2018 ◽

Vol 9 ◽

pp. 20

Author(s):

Shula Zuleika Sumana ◽

Sri Lelyati C Masulili ◽

Robert Lessang

Keyword(s):

Connective Tissue ◽

Acellular Dermal Matrix ◽

Gingival Recession ◽

Root Coverage ◽

Dermal Matrix ◽

Connective Tissue Graft ◽

Tissue Graft ◽

Operative Data ◽

Subepithelial Connective Tissue Graft ◽

Acellular Dermal

Objective: This study aims to evaluate periodontal clinical conditions after treatment for gingival recession (GR) using subepithelial connective tissue graft (SCTG) and acellular dermal matrix (ADM).Methods: Ten patients with Miller’s Class I and II recessions that had been treated with SCTG or ADM at the Periodontics Outpatient Department at Universitas Indonesia were selected for this study. The pre-operative data for GR, clinical attachment levels (CAL), and attached gingiva (AG) were retrieved from the patients’ medical records. The patients were recalled and the post-operative data were recorded.Results: The application of SCTG and ADM yields significant changes to GR, CAL, and AG levels. A comparison of two groups at the post-operative assessment stage showed no statistically significant differences, in terms of GR, CAL, and AG.Conclusion: SCTG and ADM yield similar outcomes in the treatment of GR. As such, ADM may be suggested as an alternative to SCTG for root coverage.

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Palatal Harvesting Technique Modification for Better Control of the Connective Tissue Graft Dimensions

Brazilian Dental Journal ◽

10.1590/0103-6440201302343 ◽

2013 ◽

Vol 24 (6) ◽

pp. 565-568 ◽

Cited By ~ 1

Author(s):

Danilo Maeda Reino ◽

Arthur Belem Novaes Jr. ◽

Marcio Fernando de Moraes Grisi ◽

Luciana Prado Maia ◽

Sergio Luis Scombatti de Souza

Keyword(s):

Connective Tissue ◽

Donor Site ◽

Case Series ◽

Gingival Recession ◽

Connective Tissue Graft ◽

Tissue Graft ◽

Partial Thickness ◽

Harvesting Technique ◽

Subepithelial Connective Tissue Graft ◽

Graft Thickness

Subepithelial connective tissue graft (SCTG) has been extensively used for a variety of clinical applications. However, the surgical procedure may not allow control of graft thickness. The purpose of this case series is to illustrate a modification to the single incision palatal harvesting technique in order to control the SCTG thickness without increasing patient discomfort. Fifty cases from thirty systemically and periodontally healthy patients with at least one multiple gingival recession were treated with coronally advanced flaps combined with a SCTG. The palatal area served as the donor site, from where a single perpendicular incision was made to obtain a full thickness flap. Next, 1-2 mm of the flap was elevated and dissected to obtain a partial thickness flap. The graft remained attached to the full-partial thickness flap. After determining the desired SCTG thickness, the graft was harvested from the palatal flap. The patients healed uneventfully at 7 days postoperatively and primary closure was obtained for all palatal donor sites. The SCTG length and width varied depending on the needs of each case, but the SCTG thickness was well controlled with only 0.24 mm standard deviation. The suggested modification granted control of the SCTG dimensions and achieved complete wound closure within a week.

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Vestibular incisional subperiosteal tunnel access versus coronally advanced flap with connective tissue graft for root coverage of Miller’s class I and II gingival recession: A randomized clinical trial

Journal of Advanced Periodontology & Implant Dentistry ◽

10.15171/japid.2019.003 ◽

2019 ◽

Vol 11 (1) ◽

pp. 12-20

Author(s):

Saeed Sadat Mansouri ◽

Omid Moghaddas ◽

Narjes Torabi ◽

Katayoun Ghafari

Keyword(s):

Connective Tissue ◽

Gingival Recession ◽

Control Group ◽

Root Coverage ◽

Control Groups ◽

Coronally Advanced Flap ◽

Connective Tissue Graft ◽

Tissue Graft ◽

Subepithelial Connective Tissue Graft ◽

And Control

Background and aims. This study aimed to compare the clinical efficacy of vestibular incisional subperiosteal tunnel access (VISTA) with subepithelial connective tissue graft versus a coronally advanced flap (CAF) with subepithelial connective tissue graft for the treatment of gingival recession defects. Materials and methods. This randomized clinical trial was performed on 24 recession defects that were bilaterally Miller’s class I or II in the maxillary canine and premolar area. One quadrant in each patient was selected randomly to receive VISTA (test group) or CAF (control group) with connective tissue graft. Clinical parameters measured at baseline and at 3- and 6- month postoperative intervals included recession width (RW), recession depth (RD), keratinized tissue width (KTW), clinical attachment level (CAL) and probing depth (PD). Results. Healing was uneventful in both the test and control groups. At the 6-month follow-up, there was a significant decrease in RD, RW and CAL and an increase in KTW in both the test and control groups. The PD remained unchanged. At 3 and 6 months, no statistically significant differences were found between VISTA and CAF for root coverage and clinical attachment gain. Mean root coverage (MRC) was 70.69% and 67.22% in the test and control group, respectively. VISTA demonstrated higher frequency of complete root coverage (CRC) compared to CAF: 50% vs. 33% (P<0.05). The mean KTW was 2.4±0.7 mm at the test and 2.7±0.8 mm at the control sites (P>0.05) Conclusion. VISTA, as a minimally invasive approach, can enhance root coverage, KTW and clinical attachment gain; therefore, it can be used as a substitute for CAF with connective tissue graft as a gold standard for root coverage.

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