Treatment of Gingival Recession with Hypersensitivity using Free Soft-tissue Graft Procedures

2020 ◽  
Vol 1 (1) ◽  
pp. 01-06
Author(s):  
Deliverska E
Keyword(s):  
Soft Tissue ◽  
Treatment Options ◽  
Gingival Recession ◽  
Control Group ◽  
Root Coverage ◽  
Free Gingival Graft ◽  
Coronally Advanced Flap ◽  
Tissue Graft ◽  
Soft Tissue Graft ◽  
Gingival Graft

Background The main goal of root coverage procedure is complete coverage of the recession defect with a good esthetic result related to the adjacent soft tissues and minimal probing depth after the healing process. Purpose The aim of this study was to compare the efficiency of surgical and nonsurgical treatment options in patients with gingival recession and dentin hypersensitivity (DH). Material and methods 60 patients with gingival recession Miller Class I and II with hypersensitivity and esthetic concerns were included. 30 of them were treated with free soft-tissue graft procedures and control group of 30 people were treated with anti-hypersensitivity gel. Surgically treated patients were separated in two groups: 20 of them- with coronally advanced flap with sub-epithelial connective tissue graft and 10 of them- with free gingival graft. Results We achieved full coverage on the exposed root surfaces in 18 patients treated with coronally advanced flap and de-epithelized graft and partial root coverage in two of them. Patients treated with free gingival graft procedure achieved full root coverage in 6 of them and partial on 4 of them (GR=1 mm after surgery). Surgical treatment led to resolution of the esthetic issues of the patients and elimination or reduction of the DH. In control group there were partial elimination of root sensitivity. Conclusion: In surgical treated group with both techniques we achieved resolution of DH and coverage of the root surface with healthy keratinized tissues. Surgery may be considered for treatment options of DH depending on the indications.

Surgical Management of Gingival Recession Using Free Gingival Autograft: A Case Report

2019 ◽  
Vol 3 (2) ◽  
pp. 81-83
Author(s):  
Manisha Neupane ◽  
Manoj Humagain ◽  
Mahima Subba ◽  
Simant Lamichhane ◽  
Asmita Dawadi
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Surgical Techniques ◽  
Gingival Recession ◽  
Free Gingival Graft ◽  
Tissue Graft ◽  
Soft Tissue Graft ◽  
Tunnel Technique ◽  
Rotational Flap ◽  
Gingival Graft

Gingival recession leads to dentinal hypersensitivity, aesthetic problems, root caries, cervical abrasion and difficulty in oral hygiene maintenance. Managing gingival recession often is a great challenge for practitioners. Different surgical techniques have been advocated for root coverage like free soft tissue graft procedures free gingival graft and sub-epithelial connective tissue graft, pedicle soft tissue graft rotational flap and flap advancement, pouch and tunnel technique and guided tissue regeneration. This case report displays use of free gingival graft for management of patient of age 22 years with Miller’s Class I recession defect in lower left mandibular central incisor.

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.

Free Gingival Graft: A Surgical Boon for Receding Gums

2014 ◽  
Vol 5 (2) ◽  
pp. 25-28
Author(s):  
R Vinaya Kumar ◽  
Shriparna Biswas ◽  
Sruthi K Nair ◽  
Madhuri Kotha ◽  
BM Shivaprasad
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Gingival Recession ◽  
Root Caries ◽  
Class Iii ◽  
Root Coverage ◽  
Postoperative Results ◽  
Free Gingival Graft ◽  
Reliable Procedure ◽  
Gingival Graft

ABSTRACT Gingival recession is defined as displacement of the soft tissue margin apical to the cementoenamel junction. The esthetic demand together with reduction of root sensitivity and management of root caries or cervical abrasion are the main indications for root coverage. Available literature indicates that free gingival graft (FGG) is a reliable procedure for root coverage with a success rate ranging from 76 to 95.5%. In this case report, a 32-year-old female patient having Miller's Class III gingival recession in relation to 31 was treated using free gingival graft with satisfactory postoperative results. How to cite this article Biswas S, Nair SK, Kotha M, Kumar RV, Shivaprasad BM. Free Gingival Graft: A Surgical Boon for Receding Gums. J Health Sci Res 2014;5(2):25-28.

scholarly journals Evaluation of Connective Tissue Grafts Versus Free Gingival Grafts

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 474-478
Author(s):  
Keerthana Baskar ◽  
Nashra Kareem ◽  
Sreedevi Dharman
Keyword(s):  
Connective Tissue ◽  
Gingival Recession ◽  
P Value ◽  
Age Group ◽  
Root Coverage ◽  
Free Gingival Graft ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Tissue Grafts ◽  
Gingival Graft

Root coverage is one of the important aims of periodontal therapy. The aim of the study was to evaluate the connective-tissue grafts (CTG) and free gingival grafts (FGG) in root coverage procedures. A retrospective study of sample size 32 was conducted. These patients underwent a root coverage procedure done using grafts. The details on which graft was obtained from patient records were reviewed and analysed between June 2019 to March 2020. Excel tabulation was done, analysed and transferred to SPSS for statistical analysis. The p value was set at 0.05. In the study, it was found that CTG was used in 56.25% of the patients and FGG was used in 43.75% of the patients undergoing root coverage procedure.  It was found that Free gingival grafts (25%) were placed more commonly in females when compared to connective tissue grafts (18.75%). However, in males, connective tissue grafts (37.5%) were placed more commonly than free gingival grafts. (18.75%) The prevalence of connective tissue graft was more when compared to free gingival graft at 36-55 years of age. Connective tissue graft was done more commonly in the age group of 15-35 years. Prevalence of connective tissue grafts was more in males than in females. Within the limits of the study, it was found that connective tissue graft (CTG) procedures performed more than free gingival graft (FGG) procedures following the gold standard for root coverage in gingival recession treatment.

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 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 Platelet Rich Fibrin as Wound Coverage of Donor Site in Free Gingival Graft

2018 ◽  
Vol 2 (1) ◽  
pp. 26-29
Author(s):  
Shweta Agrawal ◽  
Pramod Kumar Koirala ◽  
Shalini Pradhan ◽  
Ranjita Shrestha Gorkhali
Keyword(s):  
Wound Healing ◽  
Pain Perception ◽  
Donor Site ◽  
Gingival Recession ◽  
Root Coverage ◽  
Wound Coverage ◽  
Platelet Rich Fibrin ◽  
Free Gingival Graft ◽  
Keratinized Tissue ◽  
Gingival Graft

Free gingival graft is one of the technique used for root coverage so as to increase the inadequate keratinized tissue. The donor tissue is most frequently taken from the palate and generally the donor site is not covered or protected. Platelet rich fibrin is one of the good option for the wound coverage of donor site after free gingival graft so as to reduce the pain perception to patient and faster wound healing. The case report includes two cases with gingival recession, treated on the same day with free gingival graft with the use of platelet rich fibrin in the donor site in case 1 and without platelet rich fibrin in case 2 respectively which were compared for pain perception and wound healing postoperatively at 24 hours, 3 days, 5 days, 7 days and 14 days. There was less pain perception and discomfort in the donor site with the use of platelet rich fibrin and enhanced healing compared to donor site without platelet rich fibrin.

scholarly journals Combination of orthodontic movement and periodontal therapy for full root coverage in a miller class iii recession: a case report with 12 years of follow-up

2012 ◽  
Vol 23 (6) ◽  
pp. 758-763 ◽  
Author(s):  
Rafael Scaf de Molon ◽  
Érica Dorigatti de Avila ◽  
João Antonio Chaves de Souza ◽  
Andressa Vilas Boas Nogueira ◽  
Carolina Chan Cirelli ◽  
...  
Keyword(s):  
Case Report ◽  
Gingival Recession ◽  
Periodontal Therapy ◽  
Treatment Modalities ◽  
Class Iii ◽  
Root Coverage ◽  
Free Gingival Graft ◽  
Coronally Advanced Flap ◽  
Orthodontic Movement ◽  
Attached Gingiva

One of the main purposes of mucogingival therapy is to obtain full root coverage. Several treatment modalities have been developed, but few techniques can provide complete root coverage in a class III Miller recession. Thus, the aim of this case report is to present a successful clinical case of a Miller class III gingival recession in which complete root coverage was obtained by means of a multidisciplinary approach. A 17-year-old Caucasian female was referred for treatment of a gingival recession on the mandibular left central incisor. The following procedures were planned for root coverage in this case: free gingival graft, orthodontic movement by means of alignment and leveling and coronally advanced flap (CAF). The case has been followed up for 12 years and the patient presents no recession, no abnormal probing depth and no bleeding on probing, with a wide attached gingiva band. A compromised tooth with poor prognosis, which would be indicated for extraction, can be treated by orthodontic movement and periodontal therapy, with possibility of 100% root coverage in some class III recessions.

scholarly journals Platelet-rich fibrin-a cost-effective, donor less and indigenous therapy for obtaining root coverage-a case report

2017 ◽  
Vol 5 (1) ◽  
pp. 46
Author(s):  
Bharat Joshi
Keyword(s):  
Cost Effective ◽  
Gingival Recession ◽  
Class Iii ◽  
Root Coverage ◽  
Platelet Rich Fibrin ◽  
Free Gingival Graft ◽  
Coronally Advanced Flap ◽  
Attached Gingiva ◽  
Separate Clinical Entity ◽  
Rapid Healing

Among the periodontal infections, gingival recession is a separate clinical entity which demands a permanent solution plan. Treatment therapies are based on either elimination (as in case of Miller’s class I/II recession) or increasing the width of keratinized gingiva for prevention of further progression (as in case of Miller’s class III/IV recession). From the centuries, graft surgeries like free gingival graft, lateral pedicle and Coronally advanced flaps have been successful in the  treatment of gingival recession. As every technique has its own merits and demerits, clinicians have tried to stress upon addition of certain adjuncts or biomaterials to ensure rapid healing and less post-operative discomfort. Platelet concentrates are an excellent biomaterials for increasing width of attached gingiva and enhancing wound healing. They are cost effective, do not require donor tissue for harvesting and contain variety of growth factors for initiating regeneration. In this paper, Platelet-rich fibrin a 2nd generation concentrates has been used as an adjunct to Coronally advanced flap with a purpose of increasing width of keratinized gingiva, obtaining complete root coverage and achieving gingival harmony.

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