scholarly journals EFFECT OF SMOKING ON THE PERIODONTAL MICROSURGERY TECHNIQUE ON THE TREATMENT OF GINGIVAL RECESSION

Author(s):  
Renata De Araújo Barbosa ◽  
Mônica Dourado ◽  
Maria Cecília Azoubel ◽  
Roberta Santos Tunes ◽  
Érica Del Peloso Ribeiro ◽  
...  

This paper aims to evaluate the effects of smoking on periodontal microsurgery technique using the subepithelial connective tissue graft (SCTG) for treatment of gingival recession on smokers. 14 patients nonsmokers and 12 smokers were selected, presenting Miller’s Class I and II gingival recession ≥ 2.0 mm. For both groups, the subepithelial connective tissue graft was used with the aid of a surgical microscope. The clinical parameters of width and height of the gingival recession, height and thickness of keratinized tissue, probing depth and clinical attachment level were evaluated before and six months after surgery. At the end of the study, there were obtained an average percentage of 96.66% of root coverage on nonsmokers and 82.49% on smokers (p=0.03). Complete root coverage was observed in 78,57% and 50% of patients, respectively. Therapy can benefit both groups, but smokers have less favorable outcomes to root coverage with periodontal microsurgery using the SCTG.

2003 ◽  
Vol 50 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Sasa Jankovic ◽  
Bozidar Dimitrijevic

This study was designed to compare the effectiveness and predictability of GTR and connective tissue graft in the treatment of gingival recession. 15 recessions Miller class II and III were treated with bioabsorbable barrier and coronally advanced flap. The same number of defects was treated with connective tissue graft in combination with coronally advanced flap. Clinical recordings included hygiene standards and recession depth (RD) probing depth (PD), clinical attachment level (CAL) and keratinized tissue width (KT) Mean (RD) was statistically significant decreased from 5,47mm presurgery to 0.73mm with GTR (87,76%) and from 5,93mm to 0.60 with CTG (89.9%). Prevalence of complete root coverage was 40% for the GTR and 46,66% for CTG group. No statistically significant differences between treatment groups were observed in this study Treatment of gingival recessions with CTG and GTR present effective and highly predictable mucogingival plastic surgical procedures.


2022 ◽  
Vol 11 (1) ◽  
pp. 235
Author(s):  
Evgeny Weinberg ◽  
Roni Kolerman ◽  
Lazar Kats ◽  
Omer Cohen ◽  
Daya Masri ◽  
...  

(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.


2021 ◽  
Author(s):  
Evgeny Weinberg ◽  
Roni Kolerman ◽  
Omer Cohen ◽  
Alon Sebaoun ◽  
Gil Slutzkey

Abstract Aims To assess the clinical outcome (after one year) of coronally advanced flap combined with connective tissue graft for the treatment of orthodontic-associated Miller Class III gingival recession of the lower incisors. Materials and 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. 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. 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 with a concomitant increase in width of keratinized tissue. Clinical Relevance These findings suggest that combination of coronally advanced flap with connective tissue graft may significantly improve post-orthodontic Miller Class III recessions of the mandibular incisors, even when the correction of the tooth malposition is unattainable.


2017 ◽  
Vol 8 (4) ◽  
pp. 248-254
Author(s):  
Vitor J Spada ◽  
Patricia O Nassar ◽  
Nahana Cardoso ◽  
Khadidjia MB Caldato ◽  
Jordana H Pandini ◽  
...  

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.


Author(s):  
Anita Mehta

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.


2018 ◽  
Vol 9 ◽  
pp. 20
Author(s):  
Shula Zuleika Sumana ◽  
Sri Lelyati C Masulili ◽  
Robert Lessang

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.


2019 ◽  
Vol 11 (1) ◽  
pp. 12-20
Author(s):  
Saeed Sadat Mansouri ◽  
Omid Moghaddas ◽  
Narjes Torabi ◽  
Katayoun Ghafari

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.


Gels ◽  
2022 ◽  
Vol 8 (1) ◽  
pp. 31
Author(s):  
Bartłomiej Górski ◽  
Marcin Szerszeń

To improve treatment efficacy of gingival recessions (GR), chemical preparation of the exposed root surface was advocated. The aim of this study was to compare the additional influence of root biomodifications with 24% ethylenediaminetetraacetic acid (EDTA) alone or with enamel matrix derivative (EMD) on the 12 month outcomes of modified coronally advanced tunnel (MCAT) with subepithelial connective tissue graft in the treatment of multiple GR. Average root coverage (ARC), complete root coverage (CRC), reduction in GR, reduction in recession width (RW), gain in clinical attachment level (CAL), increase in gingival thickness (GT), increase in keratinized tissue width (KTW) and changes in root coverage esthetic score (RES) were evaluated. A total of 60 patients with 215 GR were enrolled. In 70, GR root surfaces were treated with EDTA + EMD, in other 72, with EDTA, while in the remaining 73 saline solution was applied. ARC was 94%, 89%, and 91% in the EDTA + EMD, the EDTA and the saline groups, respectively (p = 0.8871). Gains in clinical attachment level (CAL; 2.1 ± 1.1 mm) and RES values (9.6 ± 0.9) were significantly higher in the EDTA + EMD group, when compared with two other groups. The differences between other preoperative and postoperative parameters showed statistical significance only within but not between groups. MCAT outcomes may benefit from adjunctive use of EDTA + EMD regarding 12 month CAL gain and professionally assessed esthetics using RES following treatment of GR.


2016 ◽  
Vol 6 (3) ◽  
pp. 225-232
Author(s):  
Seema Yadav ◽  
Jaishree A Rijhwani ◽  
Vineet V Kini

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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