scholarly journals Combination Therapy for Reconstructive Periodontal Treatment in the Lower Anterior Area: Clinical Evaluation of a Case Series

2018 ◽  
Vol 6 (4) ◽  
pp. 50 ◽  
Author(s):  
Carlos Nemcovsky ◽  
Ilan Beitlitum
Keyword(s):  
Connective Tissue ◽  
Combination Therapy ◽  
Periodontal Regeneration ◽  
Case Series ◽  
Gingival Recession ◽  
Periodontal Treatment ◽  
Enamel Matrix Proteins ◽  
Simultaneous Application ◽  
Radiographic Outcomes ◽  
Tissue Grafts

Clinically, periodontal regeneration may be achieved by the application of barrier membranes, grafts, wound-healing modifiers, and their combinations. Combination therapy refers to the simultaneous application of various periodontal reconstructive treatment alternatives to obtain additive effects. This approach may lead to assemblage of different regenerative principles, such as conductivity and inductivity, space provision and wound stability, matrix development and cell differentiation. The application of autogenous connective tissue grafts during periodontal regenerative treatment with enamel matrix proteins derivative (EMD) has been previously reported. The present case series present a modified approach for treatment of severe periodontally involved lower incisors presenting with thin gingival biotype, gingival recession, minimal attached and keratinized gingiva width and muscle and/or frenum pull. In all cases a combination therapy consisting of a single buccal access flap, root conditioning, EMD application on the denuded root surfaces and a free connective tissue graft was performed. Clinical and radiographic outcomes were consistently satisfactory, leading to probing depth reduction, clinical attachment gain, minimal gingival recession, increased attached and keratinizing gingival width, elimination of frenum and/or muscle pull together with radiographic bone fill of the defects. It may be concluded that the present combination therapy for reconstructive periodontal treatment in the lower anterior area is a valuable alternative for indicated cases.

scholarly journals Palatal Harvesting Technique Modification for Better Control of the Connective Tissue Graft Dimensions

2013 ◽  
Vol 24 (6) ◽  
pp. 565-568 ◽  
Author(s):  
Danilo Maeda Reino ◽  
Arthur Belem Novaes Jr. ◽  
Marcio Fernando de Moraes Grisi ◽  
Luciana Prado Maia ◽  
Sergio Luis Scombatti de Souza
Keyword(s):  
Connective Tissue ◽  
Donor Site ◽  
Case Series ◽  
Gingival Recession ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Partial Thickness ◽  
Harvesting Technique ◽  
Subepithelial Connective Tissue Graft ◽  
Graft Thickness

Subepithelial connective tissue graft (SCTG) has been extensively used for a variety of clinical applications. However, the surgical procedure may not allow control of graft thickness. The purpose of this case series is to illustrate a modification to the single incision palatal harvesting technique in order to control the SCTG thickness without increasing patient discomfort. Fifty cases from thirty systemically and periodontally healthy patients with at least one multiple gingival recession were treated with coronally advanced flaps combined with a SCTG. The palatal area served as the donor site, from where a single perpendicular incision was made to obtain a full thickness flap. Next, 1-2 mm of the flap was elevated and dissected to obtain a partial thickness flap. The graft remained attached to the full-partial thickness flap. After determining the desired SCTG thickness, the graft was harvested from the palatal flap. The patients healed uneventfully at 7 days postoperatively and primary closure was obtained for all palatal donor sites. The SCTG length and width varied depending on the needs of each case, but the SCTG thickness was well controlled with only 0.24 mm standard deviation. The suggested modification granted control of the SCTG dimensions and achieved complete wound closure within a week.

Gingival Recession Treatment With Connective Tissue Grafts in Smokers and Non-Smokers

2006 ◽  
Vol 77 (7) ◽  
pp. 1148-1155 ◽  
Author(s):  
Kenneth J. Erley ◽  
Gary D. Swiec ◽  
Robert Herold ◽  
Frederick C. Bisch ◽  
Mark E. Peacock
Keyword(s):  
Connective Tissue ◽  
Gingival Recession ◽  
Tissue Grafts

scholarly journals Esthetic Root Coverage with Double Papillary Subepithelial Connective Tissue Graft: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Ramesh Babu Mutthineni ◽  
Ram Babu Dudala ◽  
Arpita Ramisetty
Keyword(s):  
Connective Tissue ◽  
Tissue Regeneration ◽  
Gingival Recession ◽  
Surgical Approaches ◽  
Root Coverage ◽  
Hard Tissue ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Subepithelial Connective Tissue Graft ◽  
Tissue Grafts

Patients today have become excessively concerned about esthetics. These esthetic concerns of patients have become an integral part of periodontal practice. Gingival recession is an esthetic problem that can be successfully treated by means of several mucogingival surgical approaches, any of which can be used, provided that the biologic conditions for accomplishing root coverage are satisfied with no loss of soft and hard tissue height interdentally. There are currently different techniques for root coverage which include pedicle grafts, free gingival grafts, connective tissue grafts, and guided tissue regeneration (GTR). This paper reports a case in which a new double papillary connective tissue graft technique has been used in the treatment of gingival recession.

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