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 ROOT COVERAGE USING THE SUBEPITHELIAL CONNECTIVE TISSUE GRAFT OR THE ACELLULAR DERMAL MATRIX FOR THE TREATMENT OF GINGIVAL RECESSION: A CLINICAL STUDY

2018 ◽  
Vol 9 ◽  
pp. 20
Author(s):  
Shula Zuleika Sumana ◽  
Sri Lelyati C Masulili ◽  
Robert Lessang
Keyword(s):  
Connective Tissue ◽  
Acellular Dermal Matrix ◽  
Gingival Recession ◽  
Root Coverage ◽  
Dermal Matrix ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Operative Data ◽  
Subepithelial Connective Tissue Graft ◽  
Acellular Dermal

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.

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

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.

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.

Sign in / Sign up

Export Citation Format

Share Document