scholarly journals A Comparative Study of Root Coverage using OrACELL™ Versus Subepithelial Connective Tissue Graft: A Randomized Controlled Trial

2018 ◽  
Vol 12 (1) ◽  
pp. 977-986
Author(s):  
Sean K. Vreeburg ◽  
Garth R. Griffiths ◽  
Jeffrey A. Rossmann
Keyword(s):  
Connective Tissue ◽  
Soft Tissues ◽  
Surgical Techniques ◽  
Gingival Recession ◽  
Class Iii ◽  
Root Coverage ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Attached Gingiva ◽  
Significant Difference

Background: Gingival recession is defined as a mucogingival deformity that includes the apical displacement of the marginal soft tissues below the cemento-enamel junction, loss of attached gingiva, and exposure of root surfaces. The present study aims to compare root coverage outcomes between autogenous Connective Tissue Graft (CTG) and decellularized human dermis (OrACELL™) in areas of facial gingival recession. Methods: Twenty-four non-smoking, healthy patients, with 2mm or greater facial gingival recession at a minimum of one site that is classified as Miller Class I, II, or III recession defects were included. Patients were randomly assigned to either control (CTG) or OrACELL™ (test) groups, which were treated with identical surgical techniques. All root coverage clinical parameters were evaluated at baseline, 3, and 6-months. Results: Eleven patients received CTG while 13 patients received OrACELL™; 23 of the 24 total patients had Miller Class III defects. Baseline mean Vertical Recession (VR) (CTG = 3.27±0.68 mm, OrACELL™ = 3.50±0.89 mm) and Clinical Attachment Level (CAL) (CTG = 4.86±0.74 mm, OrACELL™ = 4.73±0.90 mm) showed no significant difference between groups. At 6 months, mean VR (CTG = 0.59±0.70 mm, OrACELL™ = 1.19±1.07 mm) significantly decreased in both groups, whereas CAL (CTG = 1.90±1.00 mm, OrACELL™ = 2.42±1.17 mm) significantly increased in both groups. Differences between group means were not statistically significant. Conclusion: VR and CAL improved significantly in both the CTG and OrACELL™ groups from baseline to 6 months post-operatively, with no significant differences between groups regarding VR or CAL over the course of the study. In Miller Class III recession defects, OrACELL™ provided a viable alternative to CTG with similar results.

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

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.

scholarly journals Complete root coverage in severe gingival recession with unfavorable prognosis using the tunneling technique

2020 ◽  
Vol 12 (2) ◽  
pp. 91-95
Author(s):  
Mohammad Ahmad Javaid ◽  
Aamna Sohail ◽  
Raafay Ahmed
Keyword(s):  
Connective Tissue ◽  
Surgical Techniques ◽  
Gingival Recession ◽  
Root Surface ◽  
Root Coverage ◽  
Dentine Hypersensitivity ◽  
Gingival Margin ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Mandibular Canine

Gingival recession defined as the apical migration of the gingival margin leads to the exposure of root surface. This in turn may lead to compromised esthetics, dentine hypersensitivity and attachment loss. Severe gingival recession is typically managed surgically. However, achieving complete root coverage in cases of severe gingival recession, especially in the mandibular canine region is quite challenging. Different surgical techniques have been described in the literature to manage this condition. Tunnelling technique is one such technique which has shown promising results. Use of connective tissue graft with tunnelling technique has demonstrated favorable results in cases with mild to moderate gingival recession. Here we report a case where connective tissue graft was used in conjunction with tunnelling technique to achieve complete root coverage despite severe gingival recession and unfavorable prognosis.

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.

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

2021 ◽  
Author(s):  
Evgeny Weinberg ◽  
Roni Kolerman ◽  
Omer Cohen ◽  
Alon Sebaoun ◽  
Gil Slutzkey
Keyword(s):  
Connective Tissue ◽  
Gingival Recession ◽  
Class Iii ◽  
Root Coverage ◽  
Coronally Advanced Flap ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Keratinized Tissue ◽  
Probing Depth ◽  
One Year

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.

scholarly journals Double Papilla Graft with Amnion Membrane for Root Coverage of Isolated Recession

2016 ◽  
Vol 7 (4) ◽  
pp. 213-216
Author(s):  
Ruchi Srivastava ◽  
Zeba R Siddiqui ◽  
Rajesh Jhingran ◽  
Vivek K Bains
Keyword(s):  
Soft Tissue ◽  
Connective Tissue ◽  
Soft Tissues ◽  
Gingival Recession ◽  
Root Coverage ◽  
Coronally Advanced Flap ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Soft Tissue Problems ◽  
Amnion Membrane

ABSTRACT Gingival recession is one of the most common soft tissue problems, especially when it hinders the esthetics of a patient. Gingival recession can further lead to root caries, sensitivity, and difficulty in plaque control. Moreover, exposed roots are prone to abrasion and erosion. Periodontal plastic surgery is one of the emerging fields, which helps to meet such soft tissue problems. Currently, a variety of techniques are being used for root coverage, like pedicle grafts, coronally advanced flap, free mucosal graft, epithelial connective tissue graft, guided tissue regeneration, and acellular dermal matrix. This article highlights a case that was successfully managed by double papilla graft technique in combination with amnion membrane for root coverage of Miller class II recession defect in the mandibular canine region. In this technique, the soft tissues adjacent to the recession area were positioned over the recession defect. The main advantage of this technique is that the flap remains attached at its base so that it retains its own blood supply during transfer to a new position. It also preserves the interdental papilla, thus preserving the gingival height. As an alternative to the epithelial connective tissue graft, amnion membrane has the advantage of no invasive palatal wound, regenerative potential, and improved esthetic results. This procedure is highly sensitive and had predictable results, with a clinically significant amount of root coverage. How to cite this article Srivastava R, Siddiqui ZR, Jhingran R, Bains VK. Double Papilla Graft with Amnion Membrane for Root Coverage of Isolated Recession. World J Dent 2016;7(4):213-216.

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 Optimizing Anterior Implant Esthetics With a Vascularized Interpositional Periosteal Connective Tissue Graft for Ridge Augmentation: A Case Report

2018 ◽  
Vol 44 (4) ◽  
pp. 267-276
Author(s):  
Cimara Fortes Ferreira ◽  
Edival de Magalhães Barreto ◽  
Barbara Zini
Keyword(s):  
Connective Tissue ◽  
Soft Tissues ◽  
Treatment Plan ◽  
Class Iii ◽  
Anterior Maxilla ◽  
Ridge Augmentation ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Close Cooperation

Achieving excellence in anterior rehabilitations requires close cooperation between the periodontist and the prosthodontist. Many techniques can be used to restore the lost alveolar hard and soft tissues. The more severe the peri-implant defect, the higher the challenge and lower the predictability of the procedure. The present case consists of Seibert Class III with malaligned implants in the esthetic zone resolved with a cost-modified treatment plan to reestablish esthetics in the anterior maxilla using a rotated palatal flap. The vascularized interpositional periosteal connective tissue graft was effective in augmenting the soft tissue in the esthetic zone and remained stable over a 2-year period. Additional long-term clinical studies are necessary to support these results.

Comparative Clinical Evaluation of Acellular Dermal Matrix Allograft and Connective Tissue Graft for the Treatment of Gingival Recession

2006 ◽  
Vol 7 (2) ◽  
pp. 63-70 ◽  
Author(s):  
M.E. Rahmani ◽  
Mohammad A. Rigi Lades
Keyword(s):  
Connective Tissue ◽  
Clinical Evaluation ◽  
Acellular Dermal Matrix ◽  
Gingival Recession ◽  
Dermal Matrix ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Post Surgery ◽  
Attached Gingiva ◽  
Acellular Dermal

Abstract Aims “Gingival recession is a condition reported to occur due to abnormal periodontal anatomy, poor hygiene, excessive occlusal forces, toothbrush abrasion, and even iatrogenic or factitious causes. Though various surgical techniques are available to treat this problem, the most common is the palatal soft tissue autograft. Recently, an acellular dermal matrix allograft (ADMA) has been available as a substitute for the palatal tissue harvest. The aim of this study is to compare the ADMA with the conventional subepithelial connective tissue graft (SCTG) in the treatment of gingival recession.” Methods and Materials Fourteen patients with 20 gingival recessions of Miller's grade I and II were selected and randomized in two groups of control (SCTG) and test (ADMA). In each group ten recession defects were treated. The following parameters were measured at baseline and then at six months post surgery: recession height (RH), recession width (RW), probing depth (PD), attached gingiva (AG), keratinized gingiva (KG), and clinical attachment level (CAL). All parameters were analyzed using the two-sample t-test. Data analysis was performed using SPSS (version 11) software. Results The following mean changes (mm) occurred in SCTG and ADMA, respectively: 2.60±0.97 and 2.90±0.81 decrease in RH; 1.70±1.01 and 1.65±0.67 decrease in RW; 2.50±0.97 and 2.95±0.69 increase in KG; 2.25±0.92 and 2.65±0.85 increase in AG; 2.60±1.08 and 2.75±0.92 decrease in CAL; and finally 0.05±0.50 and 0.10±0.46 decrease in PD for the SCTG and ADMA groups, respectively. The percentage of root coverage for the two groups was 70.12%±22.81% and 72.08%±14.12%, respectively. The changes from baseline to the six-month visit were significant for both groups in terms of all parameters but PD. However, the differences in mean changes were not significant between the two groups in any of the parameters. Conclusion These findings imply the ADMA and SCTG techniques could produce the same results when used for the successful treatment of gingival recessions. In addition the ADMA could be used as an adequate alternative treatment modality for conventional techniques. Citation Rahmani ME, Lades MAR. Comparative Clinical Evaluation of Acellular Dermal Matrix Allograft and Connective Tissue Graft for the Treatment of Gingival Recession. J Contemp Dent Pract 2006 May;(7)2:063-070.

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