scholarly journals Xenogeneic collagen matrix for the treatment of multiple gingival recessions in esthetics areas: a case series with 24-month follow-up

2021 ◽  
Vol 10 (10) ◽  
pp. e349101018776
Author(s):  
Raphaella Coelho Michel ◽  
Rafael Ferreira ◽  
Erika Beatriz Spada de Carvalho ◽  
Talyta Sasaki Jurkevicz ◽  
Carla Andreotti Damante ◽  
...  
Keyword(s):  
Case Series ◽  
Collagen Matrix ◽  
Gingival Recession ◽  
Health Impact ◽  
Anterior Maxilla ◽  
Gingival Thickness ◽  
Coronally Advanced Flap ◽  
Keratinized Tissue ◽  
Surgical Pain

Introduction: Multiple gingival recessions (GR) are often associated with high hypersensitivity and esthetics concerns due to exposed roots. The collagen matrix (CM) associated with coronally advanced flap (CAF) may be a suitable treatment for multiple GR in esthetic areas. However, there is a lack of long term follow up investigations. Objective: To evaluate a 24-month follow-up of the CM + CAF treatment for multiple RT1 GRs in esthetics areas. Materials and Methods: Six patients presenting 6 adjacent Cairo’s gingival recessions type 1 (RT1) in the anterior maxilla were treated with CM + CAF, and based on these patients a brief statistical analysis was conduct. The evaluated parameters included gingival recession depth (GRD), gingival recession width (GRW), probing depth (PD), clinical attachment level (CAL), keratinized tissue width (KTW), gingival thickness (GT), and mean root coverage (MRC). Patient-related outcomes measurements (PROMs) were assessed using an oral health impact profile (OHIP-14) questionnaire and visual analogue scale (VAS).  Results: There was significant improvement in GRD, GRW, and CAL measurements at 3 months postoperatively (p<0.05). Besides, CAL also increased from 12 months to 24 months’ follow-up (p=0.0023). The MRC percentage was 82%. PD, GT, and KTW presented no statistical difference. PROMs revealed a high score for esthetics (82.2%) and a significant reduction in hypersensitivity and surgical pain/discomfort. Conclusions: Considering the limitations of a case series, the use of CM + CAF on RT1 multiple gingival recessions in esthetic areas demonstrated positive outcomes after 24 months.

scholarly journals Dynamics of Matrix Metalloproteinase-1 and -8 Secretion in Gingival Crevicular Fluid after Gingival Recession Therapy via MCAT with Either Subepithelial Connective Tissue Graft or Collagen Matrix

Biomolecules ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 731
Author(s):  
Anna Skurska ◽  
Violetta Dymicka-Piekarska ◽  
Robert Milewski ◽  
Małgorzata Pietruska
Keyword(s):  
Connective Tissue ◽  
Gingival Crevicular Fluid ◽  
Collagen Matrix ◽  
Gingival Recession ◽  
Gingival Thickness ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Keratinized Tissue ◽  
Matrix Metalloproteinase 1 ◽  
Crevicular Fluid

Objectives: The objective of this study was to determine and estimate the changing levels of matrix metalloproteinases 1 and 8 (MMP-1 and MMP-8) in GCF at consecutive stages of healing after root coverage procedure via modified coronally advanced tunnel (MCAT) combined with either sub-epithelial connective tissue graft (SCTG) or collagen matrix (CM) and also to relate those changes to clinical outcomes of both therapeutic approaches. Materials and methods: The study involved 20 patients with a total of 91 recessions. Those on one side of the mandible received MCAT plus CM while the contralateral ones MCAT plus SCTG. The evaluation of MMP-1 and MMP-8 concentrations in Gingival Crevicular Fluid (GCF) took place at baseline, then at 1, 2, and 4 weeks, and finally at 3 months after surgery. Elisa protocol was applied to determine the levels of MMP-1 and MMP-8 in GCF. Results: Three-month observation revealed statistically significant changes in MMP-1, MMP-8 and Sulcus Fluid Flow Rate (SFFR) values after implementation of both techniques. A correlation was found between a difference in MMP-1 concentrations and gain in Keratinized Tissue (KT) after SCTG and CM. MMP-8 levels and a Gingival Thickness (GT) gain observed after CM was also correlated. Conclusions: A type of augmentative material does appear to determine the dynamics of MMP-1 secretion.

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 Minimally invasive intrasulcular tunneling technique for treatment of gingival recessions- Case Series

2021 ◽  
Author(s):  
Dler Khursheed ◽  
Faraedon Zardawi
Keyword(s):  
Clinical Outcome ◽  
Minimally Invasive ◽  
Case Series ◽  
Gingival Recession ◽  
Coronally Advanced Flap ◽  
Case Series Report ◽  
Almost All ◽  
Root Surfaces ◽  
Series Report

Modification of coronally advanced flap (CAF) by tunneling procedure was applied on four cases of gingival recession. Post-operative follow up, at different time breaks recorded full coverage of almost all receded root surfaces. The technique and the clinical outcome of this technique will be demonstrated in this case series report.

scholarly journals Modified Coronally Positioned Flap for Isolated Gingival Recession, Evaluated with Root Coverage Esthetic Score System

2021 ◽  
Vol 10 (2) ◽  
pp. 43-48
Author(s):  
Dhirendra Kumar Giri ◽  
Ajit Kumar Yadav
Keyword(s):  
Gingival Recession ◽  
Application Software ◽  
Average Increase ◽  
Root Coverage ◽  
Score System ◽  
Coronally Advanced Flap ◽  
Keratinized Tissue ◽  
Statistical Application ◽  
Upper Jaw

Background: Various modifications of the coronally displaced flap have been proposed in the literature with the attempt of treating gingival recession. This study is undertaken to evaluate the predictability of the modified coronally positioned flap in isolated gingival recession not only in terms of root coverage but also with the esthetic outcome. Materials and Methods: Fifteen isolated gingival recessions with at least 1mm of keratinized tissue apical to the defect were treated with a modified coronally advanced flap. All recessions fall into Miller class I. The clinical re-evaluation was performed 3 months and 1year after the surgery. Statistical analysis was performed using statistical application software (SPSS16.0). Multivariate ANOVA was used for analysis. Results: At the 1-year examination, the average root coverage was 94.6% of the pre-operative recession depth. There was a mean clinical attachment gain of 3.3±0.1 mm at 1 year follow-up.The average increase of keratinized tissue between the baseline and the 1-year follow-up amounted to 1.53±0.13 mm. Root coverage esthetic score (RES) was recorded at the end of follow-up period. 13/15 cases showed RES score of 9 and 2/15 cases showed RES score of 6. Conclusion: The modified coronally advanced surgical technique is effective in the treatment of isolated gingival recession in the upper jaw.

All-Arthroscopic Autologous Matrix-Induced Chondrogenesis-Aided Repair of a Patellar Cartilage Defect Using Dry Arthroscopy and a Retraction System

2017 ◽  
Vol 30 (09) ◽  
pp. 925-929 ◽  
Author(s):  
Mariusz Puszkarz ◽  
Lidia Kosmalska ◽  
Martin Wiewiorski ◽  
Boguslaw Sadlik
Keyword(s):  
Magnetic Resonance ◽  
Cartilage Repair ◽  
Case Series ◽  
Collagen Matrix ◽  
International Knee Documentation Committee ◽  
Level Of Evidence ◽  
Patellar Cartilage ◽  
Radiological Data ◽  
Implantation Techniques

AbstractThe technique of all-arthroscopic autologous matrix-induced chondrogenesis (AMIC)-aided repair of patellar cartilage lesions using a retraction system and dry arthroscopy has been recently described. We report the first clinical and radiological data at a short-term follow-up. Twelve patients underwent AMIC-aided cartilage repair for a patellar lesion. All steps of the procedure were performed arthroscopically, which include the use of an intra-articularly placed retraction plate for distraction of the patellofemoral joint and evacuation of saline solution for collagen matrix insertion and fixation. Clinical assessment performed before surgery and at a mean follow-up time of 38 months (range: 24–70) included the following scores: Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC), and visual analog scale (VAS). Magnetic resonance imaging was performed at the follow-up examination, including the magnetic resonance observation of cartilage repair tissue (MOCART) score. The mean KOOS and IKDC scores increased significantly (p < 0.01) from 50.3 and 37.4 points preoperatively to 90.1 and 79.4 postoperatively. The VAS score decreased from 7.8 to 2.3 points. Mean MOCART score at follow-up was 58.3 points. Cartilage repair of patellar lesions aided by a retraction system in a dry arthroscopy setup is a promising approach. Further studies are needed to evaluate this procedure and compare it to existing matrix implantation techniques. The level of evidence for the study is 4 (case series).

scholarly journals One-Time Cortical Lamina: A New Technique for Horizontal Ridge Augmentation. A Case Series

2021 ◽  
Vol 8 (6) ◽  
pp. 22-30
Author(s):  
Vincenzo Foti ◽  
Davide Savio ◽  
Roberto Rossi
Keyword(s):  
Fibrin Sealant ◽  
Case Series ◽  
X Rays ◽  
Marginal Bone Loss ◽  
Ridge Augmentation ◽  
Keratinized Tissue ◽  
A New Technique ◽  
The One ◽  
Hard Consistency

The aim of this case series is to introduce the One-Time Cortical Lamina Technique, a simplification of the F.I.R.S.T. (Fibrinogen-Induced Regeneration Sealing Technique) in cases where only horizontal augmentation is needed. The indications for this technique are ASA2 and ASA1 anxious patients. Pre-requisites for this surgical technique are: a good amount of keratinized tissue, sufficient alveolar ridge width for placement of implants, thickness of vestibular bone at CBCT planning less than 1 mm with risk of threads exposure. Five patients with horizontal deficiencies were selected to test the efficacy of this approach. The defects were augmented using a porcine cortical bone lamina in combination with collagenated porcine bone mixed with fibrin sealant. The cortical lamina was placed only buccal to the implants and stabilized with fibrin sealant, without pins or screws. Upon completion of the implant surgery, healing abutments were connected to the implants and the soft tissue sutured around them. The healing was uneventful in all cases. Six months after surgery impressions for final restorations were taken and screwed crowns delivered. The new volume had hard consistency and the follow-up CBCT measured an average of 4.17 mm of horizontal bone augmentation. One to three years of follow up demonstrated the maintenance of vestibular volume, hard consistency and clinical stability. Intraoral X-rays showed no marginal bone loss. An advantage of this technique could be the one stage surgery that creates a stable environment for regeneration from day one.

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.

AESTHETIC AMELIORATION OF GINGIVAL RECESSION BY MODIFIED CORONALLY ADVANCED FLAP PROCEDURE: A 6 MONTHS FOLLOW-UP INTERVENTIONAL STUDY

2021 ◽  
pp. 78-80
Author(s):  
Namburi Rajesh ◽  
Rajendran Poornima
Keyword(s):  
Gingival Recession ◽  
Class I ◽  
Clinical Parameters ◽  
Pocket Depth ◽  
Coronally Advanced Flap ◽  
Probing Pocket Depth ◽  
Anterior Teeth ◽  
Flap Procedure ◽  
Attached Gingiva

Background:In recent times, aesthetics has become a major reason for the patients to seek the dentist. Gingival recession of the anterior teeth leads to long tooth appearance thereby hampering the aesthetics. The aim of the present study is to assess the efciency of modied coronally advanced ap (MCAF) technique in combination with platelet-rich brin (PRF) for recession coverage of Miller's class I and II cases. Materials and method: 10 patients with Miller's class I or class II gingiva were treated by modied coronally advanced ap (MCAF) technique in combination with platelet-rich brin (PRF). The clinical parameters such as gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment level (CAL), width of attached gingiva (WAG), thickness of attached gingiva (TAG) and the height of gingival recession (HGR) were recorded at baseline, 3 months and 6 months follow-up visits. Results: All the clinical parameters showed signicant improvement at 3 months and 6 months post-operatively when compared with the baseline values. The results obtained during the initial follow-up visit remained stable over a period of 6 months. Conclusion: MCAF is a foreseeable technique to achieve gingival recession coverage. Additionally, the use of PRF enables in improved WAG and TAG due to the release of growth factors.

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