scholarly journals An Unusual Complication in Plastic Periodontal Surgery

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Jorge Vagarinho ◽  
Sara Sardinha ◽  
Ricardo Alves
Keyword(s):  
Plastic Surgery ◽  
Oral Surgery ◽  
Unusual Complication ◽  
Root Coverage ◽  
Case Presentation ◽  
Second Molar ◽  
Plastic Periodontal Surgery ◽  
Oroantral Communication ◽  
Periodontal Plastic Surgery

Introduction. Oroantral communications may arise as a result of pathological processes or iatrogenic situations, particularly in oral surgery and implantology, but are uncommon in periodontal plastic surgery. Case Presentation. A healthy 37-year-old female patient with 5 mm Miller Class II recession on the maxillary left second molar was referred for a root coverage procedure. While preparing the recipient bed for the graft, an oroantral communication was created. Schneiderian membrane was sutured to reduce the dimension of the communication and covered with a connective tissue graft. Finally, the flap was laterally and coronally moved, and the patient instructed about postoperative precautions. This procedure allowed to achieve a complete closure of the oroantral communication and good root coverage after an 8-month follow-up. Conclusions. Different authors described different techniques that can be used to close oroantral communications. Nevertheless, in this clinical case, it was shown that the oroantral communication may be closed without having to postpone the periodontal plastic surgery.

Gingival Thickness and Outcome of Periodontal Plastic Surgery Procedures: A Meta-regression Analysis

2020 ◽  
pp. 238008442094217
Author(s):  
L. Paternò Holtzman ◽  
G. Blasi ◽  
E. Rivera ◽  
F. Herrero ◽  
K. Downton ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Plastic Surgery ◽  
Secondary Outcome ◽  
Root Coverage ◽  
Tissue Thickness ◽  
Gingival Thickness ◽  
Soft Tissue Thickness ◽  
Periodontal Plastic Surgery ◽  
The Impact

Objective: To evaluate the impact of soft tissue thickness (STT) on root coverage achieved with different periodontal plastic surgery procedures. Background: Gingival recession has been managed successfully through various surgical approaches, with great variability in outcomes. Anatomic characteristics of the recipient site and selected technique account in part for this variability. Gingival flap thickness is one of the most critical site-related characteristics. Methods: An electronic search was conducted on the major databases (PubMed, Embase, Web of Science). Human prospective studies with at least 6 mo of follow-up and with a numeric baseline measurement for gingival thickness were eligible. Only studies including nonsmoking patients were considered. Variables included surgical approach, participant characteristics, local anatomic factors, and follow-up time. Primary outcome was mean percentage root coverage (%RC) achieved, and complete root coverage was a secondary outcome. Results: A total of 42 studies were included (35 randomized controlled trials, 5 case series, 1 prospective cohort study, and 1 controlled clinical trial). Across studies, the pooled %RC was 81.9% (95% CI, 79.1% to 84.7%). The %RC was not significantly associated ( P = 0.267) with baseline soft tissue thickness; however there was a significant ( P = 0.031) inverse relationship between STT and %RC after 12-mo follow-up. Subgroup analysis showed that for no graft, there was a significant ( P = 0.025) positive relationship between STT and %RC with the exclusion of the single outlier study based on STT. Conclusions: STT plays a limited role in predicting root coverage across all approaches; when flaps are performed with no graft, the effect of STT is most critical. The length of time following surgery appears to influence outcomes, with 12-mo follow-up offering greater insight. Knowledge Transfer Statement: The results of this study can suggest to clinicians which periodontal plastic surgery technique to employ when treating challenging cases. In particular, it can be helpful when selecting the treatment approach to treat thin phenotype sites. This study could help clinicians provide a more appropriate treatment decision in such cases.

scholarly journals A new digital evaluation protocol applied in a retrospective analysis of periodontal plastic surgery of gingival recessions

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tiago Marques ◽  
N. M. Santos ◽  
Joana Fialho ◽  
J. Montero ◽  
A. Correia
Keyword(s):  
Connective Tissue ◽  
Plastic Surgery ◽  
Invasive Technique ◽  
Root Coverage ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Evaluation Protocol ◽  
Digital Evaluation ◽  
Periodontal Plastic Surgery

AbstractThis research aimed to develop a new digital evaluation protocol to objectively quantify the volumetric changes of root coverage periodontal plastic surgery when combined with connective tissue graft. Consecutive patients with Cairo recession type 1 (RT1) or Cairo recession type 2 (RT2) were treated. Accurate study models obtained at baseline and follow-ups were optically scanned. Healing dynamics were measured by calculating volume differences between time points. Nineteen patients were treated between December 2014 and January 2019. At 3-month follow-up, root coverage was 95.6% (± 14.5%) with tunnel and connective tissue graft (TUN + CTG) technique, and 88.9% (± 20.5%) with the vestibular incision subperiosteal tunnel access and connective tissue graft (VISTA + CTG) technique. Recession decreased 1.33 (± 0.86) mm and 1.42 (± 0.92) mm, respectively (p = 0.337). At 6-month follow-up, root coverage was 96.5% (± 10.4%) with the TUN + CTG and 93.9% (± 10.3%) with the VISTA + CTG. Recession decreased 1.35 (± 0.85) mm and 1.45 (± 0.82) mm, respectively (p = 0.455). Complete root coverage was achieved in 86.7% (± 0.4%) with TUN + CTG and 70.6% (± 0.5%) with VISTA + CTG. No statistically significant differences were found between techniques. The digital protocol presented proved to be a non-invasive technique for accurate measurements of clinical outcomes. Both techniques reduce gingival recessions, with no statistically significant differences.

scholarly journals Cirurgia minimamente invasiva x cirurgia convencional na taxa de recobrimento radicular e previsibilidade estética: Uma revisão integrativa

2021 ◽  
Vol 10 (5) ◽  
pp. e17610514314
Author(s):  
Silvano Santos Pinheiro ◽  
Francisco de Assis de Souza Junior ◽  
Isaías Lopes de Medeiros ◽  
Bruno Cesar de Vasconcelos Gurgel ◽  
Euler Maciel Dantas ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Plastic Surgery ◽  
Web Of Science ◽  
Gingival Recession ◽  
Root Coverage ◽  
Minimally Invasive Surgical ◽  
Periodontal Plastic Surgery

A cirurgia minimamente invasiva (CMI), é um termo que descreve procedimentos cirúrgicos pouco invasivos com ou sem instrumentos de ampliação, porém ainda não existe evidência científica se existe maior previsibilidade estética e de taxa de recobrimento radicular nas CMI em relação a cirurgia para recobrimento radicular convencional. Desta forma, foi realizada uma revisão integrativa da literatura utilizando-se a seguinte estratégia de busca: (microsurgery OR surgical AND minimally invasive surgical OR surgery AND gingival recession AND periodontal plastic surgery OR surgical AND root coverage). nas bases de dados SciELO, PubMed, Scopus, Web of Science, Science Direct, BVS e Google Acadêmico utilizando-se de artigos publicados entre os períodos de 2011 à 2019. No total foram encontrados 546 artigos e após a seleção mediante os critérios de inclusão permaneceram 05 artigos para o estudo, todos ensaios clínicos randomizados. As informações avaliadas dos artigos foram seus objetivos, tamanho da amostra, técnicas cirúrgicas realizadas, o tempo de acompanhamento e os resultados e conclusão. Com base nas análises, pode-se concluir que a CMI não necessita do uso de instrumentos de magnificação. A tunelização realizada para recobrimento radicular proporciona melhores resultados como ganho tecidual e estético em relação ao Retalho tracionado coronalmente (RTC), principalmente para as classes I e II de Miller. O uso de enxerto conjuntivo associado a CMI aumentou a previsibilidade de resultados satisfatórios.

scholarly journals Combining Techniques to Treat Isolated Deep Recession-Type Defects: A Case Report with Long-Term Stability

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
João Carnio ◽  
Anna Tereza Carnio
Keyword(s):  
Case Report ◽  
Root Coverage ◽  
Case Presentation ◽  
Term Stability ◽  
Long Term Stability ◽  
Dental Procedures ◽  
Donor Area ◽  
Deep Recession

Introduction. The purpose of this case report was to show the clinical long-term stability of a successful two-step root coverage procedure. A combination of two single techniques was used to treat an isolated deep-wide defect. Case Presentation. A 28-year-old female patient was referred in order to treat a single recession defect at #22. Due to her fear of dental procedures and a poor economic situation, the team developed an alternative solution. They used a modified apically repositioned flap (MARF) to increase the donor area and then a laterally positioned flap (LPF) to treat the root defect. Clinical evaluation at the three-year follow-up revealed complete resolution of the defect, a gain in clinical attachment, excellent esthetic results, and minor morbidity to the patient. Conclusion. The combination of the MARF and the LPF procedures was able to successfully treat a single deep recession defect with some advantages over traditional techniques such as simplicity, ideal color match of tissues, and the absence of palatal donor tissue.

When Gingival Recession Is Rescued By Periodontal Plastic Surgery: A Clinical Case Report

2017 ◽  
Vol 2 (2) ◽  
Keyword(s):  
Case Report ◽  
Surgical Techniques ◽  
Gingival Recession ◽  
Root Surface ◽  
Root Coverage ◽  
Patient Reported ◽  
Term Evaluation ◽  
Periodontal Plastic Surgery

Gingival recession is the most common mucogingival defect. It is characterized by the exposure of the tooth root surface resulting from displacement of the gingival margin below the cementoenamel junction. The denuded root surfaces compromise dental and gingival aesthetics with dentine hypersensitivity, caries proclivity, cervical abrasion and oral hygiene disability. When deciding root coverage, settled surgical techniques have been proposed and each procedure challenges to expand on limitations of the others. The purpose of this case report is to assess the esthetic correction of localized gingival recession using combined coronally positioned flap with connective tissue graft techniques. Long term evaluation, extended to two years after surgical treatment, is performed. The part of the prophylactic management to prevent potential future recessions is also enhanced. Significant increasing in keratinized and attached gingival tissues and reduction of height and width of recession were obtained. Gain of root coverage was 100% with great improvement in attachment level. Prevention of recession was accomplished and the results were stable after two years follow up. Patient-reported outcomes were satisfaction and esthetic appearance.

Post-Surgical Hemorrhage: Formation of a “Liver Clot” Secondary to Periodontal Plastic Surgery

2001 ◽  
Vol 2 (2) ◽  
pp. 42-47
Author(s):  
Edward B. Fowler ◽  
Lawrence G. Breault ◽  
Richard F. Druckman
Keyword(s):  
Plastic Surgery ◽  
Laboratory Tests ◽  
Oral Surgery ◽  
Bleeding Disorders ◽  
Active Hemorrhage ◽  
Clotting Cascade ◽  
Patient Will ◽  
Special Circumstances ◽  
Periodontal Plastic Surgery ◽  
Common Laboratory

Abstract Bleeding is a common sequela of periodontal and oral surgery. Generally, bleeding is self-limiting. Special circumstances require additional procedures to reduce or eliminate active hemorrhage. Occasionally hemorrhage can be under control when a patient is dismissed from their surgical appointment and, subsequently, the patient will experience either slow seepage of blood or extravascular clot formation. This case report describes the unique formation of a “liver clot” or “currant jelly clot” following periodontal plastic surgery. The clotting cascade and common laboratory tests to evaluate bleeding disorders are also presented.

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