scholarly journals Treatment of Gingival Recessions Class II Miller in Lower Jaw with Coronary Advanced Flap and Connective Tissue Graft-Case Report

2020 ◽  
Vol 24 (3) ◽  
pp. 60-64
Author(s):  
Antoaneta Mlachkova ◽  
Zdravka Pashova-Tasseva
Keyword(s):  
Case Report ◽  
Connective Tissue ◽  
Gingival Recession ◽  
Class Ii ◽  
Root Coverage ◽  
Coronally Advanced Flap ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Lower Jaw ◽  
Keratinized Tissue

SummaryBackground/Aim: Gingival recession is defined as apical migration if the gingival margin associated with exposure of the cement - enamel junction. The gingival recessions are major esthetic concern in patients at any age. In cases with esthetic and functional considerations mucogingival surgery is indicated. The advantages of CAF with or without CTG are making this procedure highly recommended in the esthetic zone. The results are predictable about root coverage, widening if the gingival tissues and esthetics. The aim of the recent case report is to demonstrate the succesfull combination of coronally advanced flap with connective tissue graft in the treatment of wide and deep gingival recessions.Case Report: Female patient seeking consultation with great concern” not to lose the lower canines”. She noticed elongation of the teeth in the recent years complained with tenderness while brushing them. The initial examination showed presence of multiple gingival recessions in the upper and the lower jaw. Full periodontal status was taken and following diagnosis was established – dental plaque induced gingivitis, class II gingival recession in teeth #33 and #43 (Miller`s classification), RT1 by Cairo. After cause-related therapy two surgical procedures were performed in separate sessions. Both gingival recessions were surgically treated by means of CAF with CTG.Conclusions: Despite the limitating factors such as lack of keratinized tissue in the patient’s mandible that rather difficult the performance of the technique of choise, the coronally advanced flap with connective tissue graft is predictable technique for full 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 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.

Subepithelial Connective Tissue Graft for Gingival Recession Coverage: A Case Report

2020 ◽  
Author(s):  
Anita Mehta
Keyword(s):  
Case Report ◽  
Connective Tissue ◽  
Gingival Recession ◽  
Tooth Brushing ◽  
Vulnerable Area ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Keratinized Tissue ◽  
Subepithelial Connective Tissue Graft ◽  
Dentinal Hypersensitivity

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.

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 Possibilities of modern procedures in gingival recession therapy

2003 ◽  
Vol 50 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Sasa Jankovic ◽  
Bozidar Dimitrijevic
Keyword(s):  
Connective Tissue ◽  
Gingival Recession ◽  
Clinical Attachment Level ◽  
Treatment Groups ◽  
Coronally Advanced Flap ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Keratinized Tissue ◽  
Probing Depth ◽  
Attachment Level

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.

scholarly journals Clinical impact of platelet rich plasma in treatment of gingival recessions

2008 ◽  
Vol 136 (3-4) ◽  
pp. 95-103 ◽  
Author(s):  
Zoran Aleksic ◽  
Sasa Jankovic ◽  
Bozidar Dimitrijevic ◽  
Ana Pucar ◽  
Vojkan Lazic ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Platelet Rich Plasma ◽  
Gingival Recession ◽  
Root Surface ◽  
Coronally Advanced Flap ◽  
Periodontal Tissues ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Keratinized Tissue ◽  
Prp Gel

Introduction Root coverage supported with complete regeneration of lost periodontal tissues represents the ultimate goal of gingival recession treatment. Objective This study was designed to evaluate clinical effectiveness of platelet rich plasma gel (PRP) with connective tissue graft (CTG) in the treatment of gingival recession. METHOD 15 gingival recessions Miller class I or II were treated with CTG and PRP (group PRP). Connective tissue graft was harvested from the premolar region using trap door technique. After elevation of the flap, the regional bone and root surface were smeared with activated PRP gel. CTG was also irrigated with PRP gel before placement over the exposed root surface and local bone. Fixed CTG was covered with a coronally advanced flap. The same number of gingival recessions were treated with CTG in combination with the coronally advanced flap with no PRP gel (group TVT). Clinical recordings included recession depth (RD), probing depth (PD), clinical attachment level (CAL) and keratinized tissue width (KT) before and 1 year after mucogingival surgical treatment. Results Mean value of RD was significantly decreased from 4.93?0.86 mm to 0.60?0.37 (p<0.01) with CTG and PRP and from 4.76?0.74 mm to 0.63?0.29 mm (p<0.01) in CTG group. This difference was not statistically significant. Results of the keratinized tissue width showed significant increase from 0.88? 0.30 mm presurgery to 3.78?0.49 mm (p<0.01) six months after treatment in PRP group and from 0.90?0.34 mm to 3.15?0.41 in TVT group (p<0.01). This difference was statistically significant (p>0.05). No statistically significant differences were observed between treatment groups in CAL and PD. Conclusion Clinical results validate both procedures as effective and highly predictable surgical techniques in solving gingival recession problem. Histological evaluation may confirm advantage of PRP use related to regeneration of periodontal tissues. .

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