scholarly journals Simplified protocol for horizontal and vertical post-extractive GBR with intentionally exposed PTFE membrane - Case series

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Mario Cappellin
Keyword(s):  
Case Series ◽  
Hard Tissue ◽  
Bone Maturation ◽  
Ptfe Membrane ◽  
Coronally Advanced Flap ◽  
Connective Tissue Graft ◽  
Keratinized Tissue ◽  
Correct Alignment ◽  
Bone Preservation ◽  
Secondary Healing

Purpose: Post-extractive sites often need soft and hard tissue regeneration in order to place implants with optimal functional and aesthetic conditions. The author proposed several techniques for bone preservation and regeneration: most of them requires release incisions and coronally advanced flap to obtain primary closure, so regain a correct alignment of keratinized gingiva makes mandatory a further surgery with a connective tissue graft from secondary surgical site. Case report: Since May 2018 we applied with some adjustments Open Barrier Technique (proposed by E. Funakoshi, 2005) in 152 post-extractive alveolar preservation and GBR; after 3-6 months we placed 194 implants, with 100% success and survival rate. Conclusions: Our simplified protocol allows performing vertical and horizontal GBR in post-extractive sites without release incisions: non resorbable PTFE membrane protects wound and bone graft for 6-8 week; secondary healing ensures thick keratinized tissue and bone maturation, suitable to place implants after 3-6 months.

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. .

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 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.

Root Coverage Predictability in the Treatment of Gingival Recessions on Mandibular Anterior Teeth

2021 ◽  
pp. 238008442110094
Author(s):  
M. Agusto ◽  
A. Salman ◽  
D. Parker ◽  
D. Choi ◽  
G.P. Schincaglia
Keyword(s):  
Connective Tissue ◽  
Meta Analysis ◽  
Surgical Techniques ◽  
Root Coverage ◽  
Free Gingival Graft ◽  
Coronally Advanced Flap ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Anterior Teeth ◽  
Keratinized Tissue

Introduction: Mandibular anterior teeth are most frequently affected by gingival recession. However, data regarding mucogingival treatment aimed at root coverage in this specific location are limited. Objective: The purpose of this study was to systematically review the scientific literature and to use the meta-analytic approach to address the following focused question: “What is the effectiveness of different surgical approaches on clinical and patient-related outcomes in the treatment of buccal gingival recessions on mandibular anterior teeth?” Methods: Studies were located by searching 3 electronic databases (Medline, Scopus, and Cochrane databases) and cross-referencing. Randomized and nonrandomized studies including at least 1 arm involving the use of pedicle flaps and/or free soft tissue grafts in the treatment of gingival recessions (recession type [RT] 1 and RT2) located on the buccal aspects of mandibular centrals, laterals and canines, were included in the analysis. Primary outcome was mean root coverage (mRC), expressed in percentage, based on a 3- to 12-mo follow-up observation. A Bayesian single-arm network meta-analysis was performed to identify a treatment hierarchy of the different surgical techniques. Results: Sixteen studies, with a total of 23 arms, were included in the quantitative analysis. The greatest mRC is associated with laterally positioned flap (LPF) + connective tissue graft (CTG) (91.2%) and tunnel (TUN) + CTG (89.4%), whereas LPF alone, coronally advanced flap (CAF) + CTG, and free gingival graft (FGG) showed lower mRC (79.1%, 78.9%, and 68.5% respectively). TUN + CTG provides significantly greater mRC compared to CAF+CTG. No difference among the procedures could be observed in terms of keratinized tissue width gain. Conclusions: Treatment hierarchy generated by an arm-based network meta-analysis model suggested that tunnel and laterally positioned flap, both in combination with connective tissue graft, may provide the greatest mean root coverage in the treatment of mandibular anterior recessions. Knowledge Transfer Statement: The results of the present systematic review can be used by clinicians when deciding which approach to adopt when treating buccal gingival recessions on mandibular anterior teeth. In particular, procedures based on a laterally positioned flap or a tunneling technique, both in combination with connective tissue graft, seem to be the most predictable therapeutic decision.

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