scholarly journals A Randomized Comparative Study of Two Techniques to Optimize the Root Coverage Using a Porcine Collagen Matrix

2015 ◽  
Vol 26 (5) ◽  
pp. 445-450 ◽  
Author(s):  
Danilo Maeda Reino ◽  
Luciana Prado Maia ◽  
Patrícia Garani Fernandes ◽  
Sergio Luis Scombatti de Souza ◽  
Mario Taba Junior ◽  
...  
Keyword(s):  
Test Group ◽  
Collagen Matrix ◽  
Control Group ◽  
Root Coverage ◽  
Pocket Depth ◽  
Coronally Advanced Flap ◽  
Flap Technique ◽  
Post Surgery ◽  
Keratinized Tissue ◽  
Porcine Collagen

Abstract: The aim of this randomized controlled clinical study was to compare the extended flap technique (EFT) with the coronally advanced flap technique (CAF) using a porcine collagen matrix (PCM) for root coverage. Twenty patients with two bilateral gingival recessions, Miller class I or II on non-molar teeth were treated with CAF+PCM (control group) or EFT+PCM (test group). Clinical measurements of probing pocket depth (PPD), clinical attachment level (CAL), recession height (RH), keratinized tissue height (KTH), keratinized mucosa thickness (KMT) were determined at baseline, 3 and 6 months post-surgery. At 6 months, the mean root coverage for test group was 81.89%, and for control group it was 62.80% (p<0.01). The change of recession depth from baseline was statistically significant between test and control groups, with an mean of 2.21 mm gained at the control sites and 2.84 mm gained at the test sites (p=0.02). There were no statistically significant differences for KTH, PPD or CAL comparing the two therapies. The extended flap technique presented better root coverage than the coronally advanced flap technique when PCM was used.

scholarly journals Smile esthetic evaluation of mucogingival reconstructive surgery

Odontology ◽  
2020 ◽  
Vol 109 (1) ◽  
pp. 295-302
Author(s):  
Roberto Rotundo ◽  
Luigi Genzano ◽  
Michele Nieri ◽  
Ugo Covani ◽  
David Peñarrocha-Oltra ◽  
...  
Keyword(s):  
Treatment Group ◽  
Test Group ◽  
Collagen Matrix ◽  
Gingival Recession ◽  
Control Group ◽  
Root Coverage ◽  
Coronally Advanced Flap ◽  
The Difference ◽  
And Control

AbstractTo assess the difference in smile esthetic impact of Coronally Advanced Flap (CAF) with or without the adjunct of a collagen matrix (CMX) used as root coverage procedures. Subjects with esthetic demands showing multiple upper gingival recessions of at least 2 mm, without interproximal attachment loss and cervical abrasion no more than 1 mm were recruited and randomized to CAF plus CMX or CAF alone. The Smile Esthetic Index (SEI) was adopted to quantify the quality of the smile recorded at baseline and 12 months after treatment for each treatment group. In addition, between group difference in the SEI was calculated. 24 Patients were treated and analysed. At baseline, mean gingival recession depths were 2.3 ± 0.7 mm for Test group and 2.6 ± 1.0 mm for Control group. After 1 year, the residual recession depth was 0.3 ± 0.4 mm in the CAF + CMX group and 0.6 ± 0.3 mm in the control group. The SEI at baseline was 8.1 ± 1.0 and 7.9 ± 0.7 for Test and Control group, respectively. The between groups difference at 12 months in SEI was 0.4 (95% C.I. − 0.0 to 0.8, P = 0.0697). Twelve months after treatment, CAF + CMX provided a similar SEI compared to CAF alone and the adjunct of a collagen matrix did not show a different impact on the smile esthetic appearance.

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 Type I Bovine Collagen in the Treatment of Localized Gingival Recession

2010 ◽  
Vol 1 (3) ◽  
pp. 167-173
Author(s):  
J Praveen ◽  
CD Dwarakanath ◽  
GV Prashanth ◽  
Sidharth Shankar
Keyword(s):  
Gingival Recession ◽  
Type I ◽  
Significant Gain ◽  
Root Coverage ◽  
Pocket Depth ◽  
Clinical Attachment Level ◽  
Coronally Advanced Flap ◽  
Bovine Collagen ◽  
Keratinized Tissue ◽  
Attachment Level

ABSTRACT Background Over the years, coronally advanced flap and the use of guided tissue regeneration have been among the more successful techniques in treating gingival recession. The present study compared the relative efficacies of these two techniques in treating gingival recession. Methods Twelve patients presenting with localized identical anterior recessions were taken up in a split mouth design for the study. One site was randomly assigned to be treated with coronally advanced flap supported by membrane while the other was treated with coronally advanced flap alone. Changes in clinical parameters, such as recession width, recession depth, surface area of the recession defect, width of keratinized tissue, gingival status, probing pocket depth and clinical attachment level were measured at baseline and at 3 and 6 months postoperatively. Results In the 10 patients that were followed up, both treatments resulted in a significant gain in root coverage amounting to a mean gain of 66.49% in the membrane group and 65.56% in the CAF group. The differences in root coverage and the clinical attachment level gains between the groups were not significant. However, significant gain in the width of keratinized tissue was seen in the membrane group after treatment. Conclusion This study suggests that coronally advanced flap procedure provides a predictable, simple and convenient technique in the treatment of localized class I gingival recession. Combining this technique with the placement of a bioabsorbable membrane does not seem to improve the results. The addition of a membrane, however, increases the width of keratinized tissue.

scholarly journals Coronally advanced flap with or without porcine collagen matrix for root coverage: a randomized clinical trial

2016 ◽  
Vol 20 (9) ◽  
pp. 2539-2549 ◽  
Author(s):  
Ana Regina Oliveira Moreira ◽  
Mauro Pedrine Santamaria ◽  
Karina Gonzales Silvério ◽  
Marcio Zaffalon Casati ◽  
Francisco Humberto Nociti Junior ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Collagen Matrix ◽  
Root Coverage ◽  
Coronally Advanced Flap ◽  
Porcine Collagen

scholarly journals Clinical Evaluation of the Efficacy of Coronally Advanced Flap in Combination with Platelet-Rich Fibrin Membrane in the Treatment of Miller Class I Gingival Recessions

2020 ◽  
Vol 8 (D) ◽  
pp. 7-13
Author(s):  
Omar Alaood ◽  
Mohammed Alasqah ◽  
Nawaf Alhomodi ◽  
Noorah Alqahtani ◽  
Khalid Gufran ◽  
...  
Keyword(s):  
Test Group ◽  
Gingival Recession ◽  
Tissue Loss ◽  
Control Group ◽  
Root Coverage ◽  
Invasive Approach ◽  
Platelet Rich Fibrin ◽  
Coronally Advanced Flap ◽  
Attached Gingiva ◽  
Soft Tissue Loss

BACKGROUND: Gingival recession has been associated with dentinal hypersensitivity, root caries, and esthetic compromise. Root coverage procedures aim at providing both tangible and intangible benefits to the patients. Various procedures have been tried to obtain root coverage of single-rooted teeth. Miller Classes I and II gingival recessions hold out the best promise for root coverage as there is no interdental bone and soft-tissue loss associated with these recessions. AIM: The objective of the study was to evaluate and compare the effectiveness of coronally advanced flap (CAF) with platelet-rich fibrin (PRF) membrane with CAF + connective tissue graft (CTG) on recession coverage. MATERIALS AND METHODS: A total of 16 patients required recession coverage for a single tooth were divided into two groups. The test group received CAF + PRF while the control group got CAF + CTG. Different parameters were taken preoperatively (amount of recession, width, and thickness of attached gingiva) and repeated for the two groups 2 months after surgery. RESULTS: Comparing the two groups after 2 months from surgery showed that the PRF not only has an effect in the management of recession but also has a greater effect on tissue thickness. CONCLUSION: PRF is a minimum invasive approach and a promising material for root coverage and manipulating the gingival biotype.  

scholarly journals The treatment of gingival recessions - Our experience

2016 ◽  
Vol 6 (22) ◽  
pp. 85-91
Author(s):  
Ivan Lulchev Chenchev ◽  
Dimitar Todorov Atanasov ◽  
Dilyana Vicheva
Keyword(s):  
Connective Tissue ◽  
Test Group ◽  
Class Ii ◽  
Class I ◽  
Control Group ◽  
Root Coverage ◽  
Gingival Thickness ◽  
Coronally Advanced Flap ◽  
Connective Tissue Graft ◽  
Tissue Graft

Abstract OBJECTIVE. The purpose of this study was to compare the options for treatment of Miller’s Class I and Class II gingival recessions using coronally advanced flap (CAF) and platelet-rich fibrin membrane (PRFm) with CAF and connective tissue graft (CTG). MATERIAL AND METHODS. A surgical treatment was carried out on 30 subjects (23 women and 7 men), with a total of 118 symmetrical recessions of Class I and Class II by Miller on different places of the jaws, using two different methods. On one side of the jaw was held a plastic covering of the recessions with CAF in combination with PRFm (test group), and on the other side – CAF in combination with connective tissue graft (control group). The clinical evaluation includes: gingival recession depth (GRD), probing pocket depth (PPD), clinical attachment level (CAL), keratinized gingival width (KGW), gingival thickness (GTH), mean percent of root coverage (RC %). The results were observed six months postoperatively. RESULTS. The average values for the GRD measured six months postoperatively for the control group were 0.37±0.36 mm and 0.70±0.41 mm for the test group. The results for CAL for the control group were 2.01±0.44 mm and 2.28±0.50 mm for the test group, while the mean percentage of root coverage (RC %) was 90.29±9.05% for the control group and 80.48±10.19% for the test group. The values for GTH were 1.04±0.16mm for the control group and 0.92±0.09 mm for the test group. CONCLUSION. Both compared methods show good results in terms of all evaluated parameters. The group treated with CAF + CTG showed better results with a statistically significant difference for the RC% and the average values for GRD, GTH and CAL. The results of our study demonstrate a good potential for PRFm used in the treatment of Miller’s Class I and Class II gingival recessions.

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 Efficacy of a New-generation Platelet-rich Fibrin in the Treatment of Periodontal Intrabony Defects: a Randomized Clinical Trial

2021 ◽  
Author(s):  
Boroka Klara Csifo-Nagy ◽  
Eleonora Solyom ◽  
Vera Lili Bognar ◽  
Annamaria Nevelits ◽  
Ferenc Dori
Keyword(s):  
Positive Impact ◽  
Test Group ◽  
Gingival Recession ◽  
Control Group ◽  
Intrabony Defects ◽  
Pocket Depth ◽  
Platelet Rich Fibrin ◽  
Registration Number ◽  
Enamel Matrix Derivatives ◽  
New Generation

Abstract Background: The aim of the study was to clinically evaluate the healing of intrabony defects after treatment with a new generation of platelet-rich fibrin (A-PRF+) respect to enamel matrix derivatives (EMD). Methods: Thirty (30) intrabony defects of 18 patients (9 males, 9 females) were randomly treated with A-PRF+ (test, n=15) or EMD (control, n=15). The following clinical parameters were recorded at baseline and 6 months after surgery: pocket depth (PD), gingival recession (GR) and clinical attachment level (CAL). After debridement the intrabony defects were filled with A-PRF+ in the test group, respectively with EMD in the control group, and fixed with sutures to ensure wound closure and stability.Results: Both treatment methods resulted in statistically significant PD reductions, respectively CAL gains six months post-operatively. No statistically significant differences were found between the two groups as the mean CAL gain was 2.33±1.58 mm in the A-PRF+ group, respectively 2.60±1.18 mm in the EMD group (p < 0.001).Conclusion: Within the limits of this study the new-generation platelet-rich fibrin seems to be as clinically effective as EMD in the surgical treatment of intrabony defects. Treatment with A-PRF+ or EMD resulted in reliable clinical outcomes. The use of A-PRF+ as a human autologous product can give a positive impact on periodontal healing.Clinical Relevance: A-PRF+ may be suitable for the treatment of intrabony periodontal defects. Trial registration number (TRN): NCT04404374 (ClinicalTrials.gov ID)Date of registration: 19.05.2020., retrospectively registered

Platelet Derived Growth Factor Secretion and Bone Healing After Er:YAG Laser Bone Irradiation

2011 ◽  
Vol 37 (sp1) ◽  
pp. 195-204 ◽  
Author(s):  
Gavriel Kesler ◽  
Dana Kesler Shvero ◽  
Yariv Siman Tov ◽  
George Romanos
Keyword(s):  
Growth Factor ◽  
Laser Irradiation ◽  
Bone Healing ◽  
Er:Yag Laser ◽  
Test Group ◽  
Significant Rise ◽  
Platelet Derived Growth Factor ◽  
Control Group ◽  
Saline Irrigation ◽  
Post Surgery

Er:YAG laser irradiation has been reported to enhance wound healing. However, no studies have evaluated the synthesis of growth factors after laser irradiation. The present study investigated the effects of laser irradiation on the amount of secretion of platelet derived growth factor (PDGF) in the wound, clarifying the effects of the Er:YAG laser on the bone healing. Osteotomies were prepared in the tibiae of 28 rats using an Er:YAG laser (test group). Maximum power of 8 watts, energy per pulse of 700 mJ, and frequency up to 50 Hz were used. The laser was used with external water irrigation, a spot size of 2 mm, energy per pulse of 500 to 1000 mJ/pulse, and energy density of 32 J/cm2. Twenty eight additional rats served as a control group and their osteotomies were prepared with a drill 1.3 mm in diameter at 1000 rpm, with simultaneous saline irrigation. Two rats from the tested group and 2 from the control group were sacrificed on each day following surgery (1–14 days), and the tissue specimens were prepared for histologic evaluation. Immunohistochemical staining with anti-PDGF was performed after histologic examination. The difference between the PDGF staining intensities of the 2 treatment groups was analyzed using a multivariate logistic regression test. A significant rise in PDGF staining occurred in both groups 2–3 days following surgery. However, while high PDGF counts remained for the 2-week experimental period in the laser group, PDGF levels in the control group returned to baseline levels 8 days post surgery. The 2 groups (laser and control) were found to be different throughout the experiment, and the rat type was found to be a significant predictor (P  =  .000011). The present study demonstrated that Er:YAG laser irradiation seems to stimulate the secretion of PDGF in osteotomy sites in a rat model. It is possible that the high levels of PDGF are part of the mechanism that Er:YAG irradiation enhances and improves the healing of osteotomy sites.

Sign in / Sign up

Export Citation Format

Share Document