Laterally displaced flap along with subepithelial connective tissue graft for root coverage of isolated gingival recession in thin biotype patients: A report of 4 cases

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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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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Root coverage using subepithelial connective tissue graft with platelet-rich plasma in the treatment of gingival recession: A clinical study

Journal of Pharmacy And Bioallied Sciences ◽

10.4103/0975-7406.163530 ◽

2015 ◽

Vol 7 (6) ◽

pp. 530 ◽

Cited By ~ 1

Author(s):

B. V. V. Srinivas ◽

N Rupa ◽

KV Halini Kumari ◽

S. S. V. Prasad ◽

U Varalakshmi ◽

...

Keyword(s):

Clinical Study ◽

Connective Tissue ◽

Platelet Rich Plasma ◽

Gingival Recession ◽

Root Coverage ◽

Connective Tissue Graft ◽

Tissue Graft ◽

Subepithelial Connective Tissue Graft

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Free Gingival Autograft and Subepithelial Connective Tissue Graft for the Treatment of Gingival Recession: A Brief Review and Report of Three Cases

Journal of Contemporary Dentistry ◽

10.5005/jp-journals-10031-1176 ◽

2016 ◽

Vol 6 (3) ◽

pp. 225-232

Author(s):

Seema Yadav ◽

Jaishree A Rijhwani ◽

Vineet V Kini

Keyword(s):

Connective Tissue ◽

Gingival Recession ◽

Root Coverage ◽

Recipient Site ◽

Advantages And Disadvantages ◽

Free Gingival Graft ◽

Connective Tissue Graft ◽

Tissue Graft ◽

Attached Gingiva ◽

Subepithelial Connective Tissue Graft

ABSTRACT Gingival recession is the migration of the free gingival margin apical to the cementoenamel junction. There are various factors contributing toward gingival recession apart from periodontal disease that include faulty tooth brushing, tooth position or malaligned teeth, high muscle or frenal attachment, alveolar bone dehiscence, orthodontic forces, and iatrogenic factors leading to problems of esthetics, hypersensitivity, and root caries. Several periodontal plastic surgical techniques have been introduced in the previous literature aiming to correct marginal tissue recessions, the predictability of which depends upon careful evaluation of the defect type, presence of attached gingiva, keratinized tissue width, and presence of single or multiple gingival recessions. The use of free gingival graft (FGG) and subepithelial connective tissue graft (SCTG) in root coverage is indicated for the treatment of single or multiple gingival recessions. Although both FGGs and SCTGs provide significant reduction in recession depth and clinical attachment gain for Miller's Class I and II gingival recession defects, SCTG seems to offer root coverage with a better color match between donor and recipient site tissue rendering better esthetics. Considering the advantages and disadvantages of FGG and SCTG in root coverage procedures, the following case reports describe the clinical results using FGG by Miller's technique, and using SCTGs by technique of Langer and Langer, and Zabalegui tunnel technique for the treatment of gingival recession. How to cite this article Rijhwani JA, Kini VV, Pereira R, Yadav S. Free Gingival Autograft and Subepithelial Connective Tissue Graft for the Treatment of Gingival Recession: A Brief Review and Report of Three Cases. J Contemp Dent 2016;6(3):225-232.

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Esthetic Root Coverage with Double Papillary Subepithelial Connective Tissue Graft: A Case Report

Case Reports in Dentistry ◽

10.1155/2014/509319 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5

Author(s):

Ramesh Babu Mutthineni ◽

Ram Babu Dudala ◽

Arpita Ramisetty

Keyword(s):

Connective Tissue ◽

Tissue Regeneration ◽

Gingival Recession ◽

Surgical Approaches ◽

Root Coverage ◽

Hard Tissue ◽

Connective Tissue Graft ◽

Tissue Graft ◽

Subepithelial Connective Tissue Graft ◽

Tissue Grafts

Patients today have become excessively concerned about esthetics. These esthetic concerns of patients have become an integral part of periodontal practice. Gingival recession is an esthetic problem that can be successfully treated by means of several mucogingival surgical approaches, any of which can be used, provided that the biologic conditions for accomplishing root coverage are satisfied with no loss of soft and hard tissue height interdentally. There are currently different techniques for root coverage which include pedicle grafts, free gingival grafts, connective tissue grafts, and guided tissue regeneration (GTR). This paper reports a case in which a new double papillary connective tissue graft technique has been used in the treatment of gingival recession.

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Comparison of acellular dermal matrix allograft (ADMA) and a subepithelial connective tissue graft (SCTG) for the treatment of gingival recession

Journal of Advanced Periodontology & Implant Dentistry ◽

10.34172/japid.2020.004 ◽

2020 ◽

Vol 12 (1) ◽

pp. 11-17

Author(s):

Niloofar Jenabian ◽

Mohadese Yazdanpanahbahabadi ◽

Parya Haghpanah Aski ◽

Ali Bijani

Keyword(s):

Connective Tissue ◽

Test Group ◽

Acellular Dermal Matrix ◽

Gingival Recession ◽

Root Coverage ◽

Dermal Matrix ◽

Connective Tissue Graft ◽

Tissue Graft ◽

Subepithelial Connective Tissue Graft ◽

Acellular Dermal

Background. This study aimed to evaluate the effect of acellular dermal matrix allograft (ADMA) for the treatment of gingival recession as a substitute for subepithelial connective tissue graft (SCTG). Methods. In this controlled clinical trial, 18 teeth were selected in nine subjects with bilateral gingival recession. One side was treated with SCTG and a coronally displaced flap as the control group, and the other side was treated with ADMA and a coronally displaced flap as the test group. Probing pocket depth (PPD), clinical attachment level, vertical recession depth, recession width, gingival thickness, keratinized tissue width, and the root coverage percentage were measured before the surgery and at 1-, 3-, and 6-month postoperative intervals. The healing index, pain index, and patient satisfaction were also investigated. The data were analyzed with a general linear model (GLM) repeated measures and paired t-test. Results. All the parameters improved except for PPD; however, a comparison between the groups did not reveal statistically significant differences. Only root coverage percentage and pain index were significantly lower in the test group. The average percentage of root coverage in the control and test groups were 82.01±16.62% and 64.44±9.4%, respectively. Conclusion. Both methods resulted in improvements in the clinical results. However, the use of the ADMA led to less pain and root coverage in comparison with the SCTG method.

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Use of Subepithelial Connective Tissue Graft for Root Coverage

World Journal of Dentistry ◽

10.5005/wjoud-2-2-159 ◽

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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Optimizing Gingival Biotype Using Subepithelial Connective Tissue Graft: A Case Report and One-Year Followup

Case Reports in Dentistry ◽

10.1155/2011/263813 ◽

2011 ◽

Vol 2011 ◽

pp. 1-3

Author(s):

Harpreet Singh Grover ◽

Anil Yadav ◽

Priya Yadav ◽

Prashant Nanda

Keyword(s):

Connective Tissue ◽

Gingival Recession ◽

Gingival Tissue ◽

Root Coverage ◽

Connective Tissue Graft ◽

Tissue Graft ◽

Subepithelial Connective Tissue Graft ◽

One Year ◽

Gingival Biotype ◽

Root Surfaces

Gingival recession is the exposure of root surfaces due to apical migration of the gingival tissue margins. The principal objectives of treating a gingival recession are to achieve better esthetics and reduce hypersensitivity. The gingival biotype is an important modifying factor in the treatment of gingival recession. The purpose of this paper is to highlight the significance of changing the soft tissue biotype to a more favorable one while attempting root coverage, to achieve more stable and long-lasting results using subepithelial connective tissue graft.

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Er-Yag Laser Root Preparation During Subepithelial Connective Tissue Graft Procedures.

Journal of Dentistry And Oral Implants ◽

10.14302/issn.2473-1005.jdoi-19-2654 ◽

2019 ◽

Vol 2 (2) ◽

pp. 13-17

Author(s):

José Ricardo Kina ◽

Eunice Fumico Umeda Kina ◽

Juliana Kina ◽

Mônica Kina

Keyword(s):

Connective Tissue ◽

Er:Yag Laser ◽

Gingival Recession ◽

Root Surface ◽

Periodontal Therapy ◽

Root Coverage ◽

Yag Laser ◽

Connective Tissue Graft ◽

Tissue Graft ◽

Subepithelial Connective Tissue Graft

Areas of gingival recession cause either an esthetic problem and or root sensitivity. Obtaining predictable root coverage has become an important part of periodontal therapy. A deep, long – standing recession promoted by ANUG was treated using subepithelial connective tissue graft technique combined with decontamination of root surface by using Er:YAG laser. Our clinical findigs suggest that this technique is a predictable procedure to treat gingival recession and promote root decontamination.

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Root Coverage in Miller Classes I and II associated with Subepithelial Connective Tissue Graft: A comparative Clinical Trial of Two Techniques

World Journal of Dentistry ◽

10.5005/jp-journals-10015-1446 ◽

2017 ◽

Vol 8 (4) ◽

pp. 248-254

Author(s):

Vitor J Spada ◽

Patricia O Nassar ◽

Nahana Cardoso ◽

Khadidjia MB Caldato ◽

Jordana H Pandini ◽

...

Keyword(s):

Connective Tissue ◽

Test Group ◽

Gingival Recession ◽

Control Group ◽

Root Coverage ◽

Clinical Attachment Level ◽

Connective Tissue Graft ◽

Tissue Graft ◽

Subepithelial Connective Tissue Graft ◽

Attachment Level

ABSTRACT Introduction Gingival recession is characterized by apical positioning of the gingival side in relation to the cementoenamel junction. Thus, this study aimed at evaluating the effectiveness of two surgical techniques for root coverage in patients with gingival recession of Miller class I or II. Materials and methods A total of 13 patients were selected, from the age group of 20 to 50 years, with bilateral gingival recession Miller class I or II, totaling 34 recessions. When the basic periodontal treatment was accomplished, every recession was included in one of both selected groups according to the surgical technique: Control group—Subepithelial connective tissue graft associated with coronally positioned flap technique and test group—Subepithelial connective tissue graft associated with the modified envelope technique. Patients were evaluated for 180 days, and the periodontal parameters were analyzed in 0, 90, and 180 days. Results The results showed that both surgeries were effective since they kept probe depths with periodontal health and clinical attachment gain (p < 0.05) in both groups, up from 90 days. The reduction was kept for 180 days, mainly for the control group that showed a clinical attachment gain that was still statistically significant at 180 days (p < 0.05). Regarding the root coverage, the control group showed a 90.2% of coverage while the test group showed 89.5%. Conclusion Thus, it can be concluded that both techniques, after 180 days, were effective for the health of periodontal tissues; however, a greater emphasis can be observed on the subepithelial connective tissue graft-associated coronally positioned flap technique because this technique demonstrated a greater significant gain in the clinical attachment level. Clinical significance The subepithelial connective tissue graft is used for gaining the clinical attachment level in the root coverage of patients with gingival recession Miller classes I and II. How to cite this article Spada VJ, Nassar PO, Cardoso N, Caldato KMB, Pandini JH, Randon DM, Nassar CA. Root Coverage in Miller Classes I and II associated with Subepithelial Connective Tissue Graft: A comparative Clinical Trial of Two Techniques. World J Dent 2017;8(4):248-254.

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