scholarly journals Root Coverage with Coronally Advanced Flap with Connective Tissue Graft: Literature Review and Case Report

2017 ◽  
Vol 19 (2) ◽  
pp. 25
Author(s):  
Francisco J. Jiménez Bolaños DDS ◽  
Marcelino Fernández Murillo
Keyword(s):  
Case Report ◽  
Connective Tissue ◽  
Gingival Recession ◽  
Root Coverage ◽  
Patient Reports ◽  
Coronally Advanced Flap ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Cast Doubt ◽  
Aesthetic Results

The root coverage procedure to treat gingival recessions is the best line of treatment, being the most used the coronal advanced flap.  There have been multiple clinical and aesthetic results that cast doubt on whether this procedure by adding a connective tissue graft will be a more predictable and more aesthetic regarding defect removal. In this case report a patient 24-year-old male refers hypersensitivity and aesthetic discomfort in the area of gingival recession.  An autologous graft with a coronal flap advancement of connective tissue will be used. After six months of healing the patient reports improvements in: sensitivity, plaque control and aesthetics.

scholarly journals Treatment of Gingival Recessions Class II Miller in Lower Jaw with Coronary Advanced Flap and Connective Tissue Graft-Case Report

2020 ◽  
Vol 24 (3) ◽  
pp. 60-64
Author(s):  
Antoaneta Mlachkova ◽  
Zdravka Pashova-Tasseva
Keyword(s):  
Case Report ◽  
Connective Tissue ◽  
Gingival Recession ◽  
Class Ii ◽  
Root Coverage ◽  
Coronally Advanced Flap ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Lower Jaw ◽  
Keratinized Tissue

SummaryBackground/Aim: Gingival recession is defined as apical migration if the gingival margin associated with exposure of the cement - enamel junction. The gingival recessions are major esthetic concern in patients at any age. In cases with esthetic and functional considerations mucogingival surgery is indicated. The advantages of CAF with or without CTG are making this procedure highly recommended in the esthetic zone. The results are predictable about root coverage, widening if the gingival tissues and esthetics. The aim of the recent case report is to demonstrate the succesfull combination of coronally advanced flap with connective tissue graft in the treatment of wide and deep gingival recessions.Case Report: Female patient seeking consultation with great concern” not to lose the lower canines”. She noticed elongation of the teeth in the recent years complained with tenderness while brushing them. The initial examination showed presence of multiple gingival recessions in the upper and the lower jaw. Full periodontal status was taken and following diagnosis was established – dental plaque induced gingivitis, class II gingival recession in teeth #33 and #43 (Miller`s classification), RT1 by Cairo. After cause-related therapy two surgical procedures were performed in separate sessions. Both gingival recessions were surgically treated by means of CAF with CTG.Conclusions: Despite the limitating factors such as lack of keratinized tissue in the patient’s mandible that rather difficult the performance of the technique of choise, the coronally advanced flap with connective tissue graft is predictable technique for full root coverage.

scholarly journals 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

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.

scholarly journals Tunnel/Pouch versus Coronally Advanced Flap Combined with a Connective Tissue Graft for the Treatment of Maxillary Gingival Recessions: Four-Year Follow-Up of a Randomized Controlled Trial

2020 ◽  
Vol 9 (8) ◽  
pp. 2641
Author(s):  
Souheil Salem ◽  
Leila Salhi ◽  
Laurence Seidel ◽  
Geoffrey Lecloux ◽  
Eric Rompen ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Test Group ◽  
Gingival Recession ◽  
Root Coverage ◽  
Gingival Thickness ◽  
Coronally Advanced Flap ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Keratinized Tissue

Background: The long-term stability after soft tissue graft for covering gingival recession remains a pivotal goal for both patient and periodontist. Therefore, the aim of this study was to compare the four-year outcomes of the coronally advanced flap (CAF) versus the pouch/tunnel (POT) technique, both combined with connective tissue graft (CTG), for gingival recession treatment. Methods: Forty patients were initially randomly assigned to the control group (CAF + CTG; N = 20) and the test group (POT + CTG; N = 20). Clinical outcomes included mean root coverage (MRC) and complete root coverage (CRC), gingival thickness (GT), and keratinized tissue (KT) gain. Esthetic outcomes were also analyzed using the pink esthetic score (PES) and patient-reported outcome measures (PROMs). All outcomes initially assessed at six months were extended to four years post-surgery. Results: No significant differences were observed between the two patient groups in terms of MRC and CRC. At four years, significantly greater GT and KT gain were noted in the POT + CTG group, and tissue texture enhancement was also more prominent in the test group. Conclusions: The POT + CTG technique allows for long-term clinical coverage of gingival recessions comparable to that of the CAF + CTG technique, but it potentially improves gingival thickness, keratinized tissue and esthetic results.

scholarly journals Clinical evaluation of coronally advanced flap with acellular dermal matrix graft or connective tissue graft in the treatment of gingival recession with thin periodontal phenotype: study protocol for a split-mouth randomized controlled trial

2020 ◽  
Author(s):  
Yalin Zhan ◽  
Miaozhen Wang ◽  
Xiaojing Cao ◽  
Feng Liu
Keyword(s):  
Patient Satisfaction ◽  
Connective Tissue ◽  
Gingival Recession ◽  
Root Coverage ◽  
Dermal Matrix ◽  
Coronally Advanced Flap ◽  
Connective Tissue Graft ◽  
Randomized Controlled ◽  
Tissue Graft ◽  
Periodontal Phenotype

Abstract BackgroundAmong all mucogingival deformities, gingival recession is one of the most prevalent conditions that demand surgical correction. Accordingly, root coverage procedures are essential parts of plastic periodontal surgeries. It is undeniable that autogenous tissue grafts remain the gold standard for root coverage procedures. Substantial evidences have identified that the connective tissue graft (CTG) combined with coronally advanced flap (CAF) achieves favorable root coverage of recession. Nevertheless, there are some noticeable disadvantages of harvesting autogenous tissue, such as postoperative bleeding, pain, or discomfort at the donor site, restricted tissue supply, increased morbidity, and longer operative duration. In order to overcome the drawbacks of autogenous tissue harvesting, several non-vital substitutes have been produced as alternative options for replacing connective tissue graft. Acellular dermal matrix (ADM) is an allograft derived from human skin, which has been used extensively in various areas of dental practice over the last two decades. ADM exhibits undamaged collagen and elastin matrices that has been used as a substitute for connective tissue for root coverage procedures. Although its clinical efficacy has been discussed in several reviews, conclusions about the application of this material are still unclear and controversial. Moreover, the level of evidence on the clinical outcomes and patient-reported outcomes relevant to ADM graft (ADMG) is low. Therefore, the objective of this split-mouth; randomized, controlled, clinical study is to compare the long-term clinical efficacy of ADMG combination with CAF on root coverage, aesthetics and patient satisfaction with CTG combination with CAF for gingival recession with thin periodontal phenotype, hoping to provide some reference to dentists.Methods/designForty participants with bilateral Miller Class I/II gingival recession randomly received ADMG (test group) on one side and CTG (control group) on the contralateral side in conjunction with CAF. Gingival recession depth (GRD), gingival recession width (GRW), keratinized tissue width (KTW) are measured at baseline, 2, 4, 12, 24, 48 and 96 weeks. Mean root coverage (MRC), complete root coverage (CRC), root coverage aesthetic score (RES), color change (∆E), and patient satisfaction are assessed in postoperative follow-up.DiscussionCAF combined with CTG has been shown as a predictable technique in root coverage. At present, there is limited long-term data evaluating ADM on root coverage, aesthetics and patient satisfaction for the treatment of gingival recession with thin periodontal phenotype. The result of this split-mouth randomized controlled clinical studies is performed to evaluate the long-time efficacy of ADM, particularly when compared to the “gold standard” (CTG), contributing to an advanced treatment strategy of gingival recession with ideal clinical outcome. Trial registrationInternational Clinical Trials Registry Platform (ICTRP), ID: ChiCTR2000033230. Registered on 25 May 2020, http://www.chictr.org.cn/showproj.aspx?proj=54052

scholarly journals Coronally Advanced Flap with Connective Tissue Graft for Treating Orthodontic-Associated Miller Class III Gingival Recession of the Lower Incisors: A One-Year Retrospective Study

2022 ◽  
Vol 11 (1) ◽  
pp. 235
Author(s):  
Evgeny Weinberg ◽  
Roni Kolerman ◽  
Lazar Kats ◽  
Omer Cohen ◽  
Daya Masri ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Gingival Recession ◽  
Class Iii ◽  
Root Coverage ◽  
Coronally Advanced Flap ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Keratinized Tissue ◽  
Probing Depth ◽  
One Year

(1) Background: To assess the clinical outcome of coronally advanced flap combined with connective tissue graft for the treatment of orthodontic-associated Miller Class III gingival recession of the lower incisors. (2) Methods: This study included 15 patients who had undergone orthodontic treatment prior to development of recession. Measurements of recession depth, recession width, probing depth, and width of keratinized tissue were performed clinically immediately before surgery and after one year. In addition, digital measurements of recession depth, recession width, and root coverage esthetic score were performed on intraoral photographs. (3) Results: Significant reduction was observed for probing depth, recession depth, and recession width at one year, with significant increase in width of keratinized tissue. Mean root coverage was 83 ± 24% for recession depth, while complete root coverage was achieved in 10 out of 21 recessions (48%). The average root coverage esthetic score at 12 months was 7.1 ± 2.6. An interaction was found between initial recession depth and mean root coverage. (4) Conclusions: Within the limitations of this study, our results confirm that combination of coronally advanced flap and connective tissue graft is effective in reducing post-orthodontic Miller Class III recessions of the mandibular incisors, even when the correction of the tooth malposition, is unattainable.

Use of Subepithelial Connective Tissue Graft for Root Coverage

2011 ◽  
Vol 2 (2) ◽  
pp. 159-162
Author(s):  
Sheela Kumar Gujjari ◽  
MB Harsha ◽  
Deepak Prasad
Keyword(s):  
Case Report ◽  
Connective Tissue ◽  
Gingival Recession ◽  
Root Coverage ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Anterior Teeth ◽  
Subepithelial Connective Tissue Graft ◽  
Stable Result

ABSTRACT Until recently, periodontal therapy was predominantly focused on establishing biologically and functionally stable periodontium. The presence of mucogingival problems and gingival recession around anterior teeth exemplifies a situation in which a treatment modality that addresses not only biological and functional but also esthetic demands are required from the periodontist. The advent of procedure such as subepithelial connective tissue graft in the mid-1980s and its various modifications thereafter, have led to improved and more predictable outcomes of root coverage. Thus, the present day clinicians have become more capable of addressing the esthetic demands of their patients. This case report shows the usage of subepithelial connective tissue graft for root coverage of upper right first premolar, which shows successful root coverage with a stable result. The technique used here created a healthy, functional and esthetic gingival unit that appeared resistant to further breakdown at a 6-month follow-up.

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