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

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.

Author(s):  
Harish Kumar Shah ◽  
Shashi Kant Chaudhary ◽  
Khushboo Goel ◽  
Sajeev Shrestha

Gingival recession is one of the aesthetic concern for a beautiful smile. In an aesthetically driven era, root coverage requires consideration of all prognostic factors for successful results. This paper reports a case of treatment of Miller’s Class I gingival recession involving multiple teeth. A modified coronally advanced flap procedure was performed. At the postoperative follow-up visits, healing was uneventful. After 9 months, excellent aesthetic result was achieved with complete root coverage. Periodontal health was normal and the patient was satisfied with the result.


2019 ◽  
Vol 7 (1) ◽  
pp. 29 ◽  
Author(s):  
Zvi Artzi ◽  
Shiran Sudri ◽  
Ori Platner ◽  
Avital Kozlovsky

The purpose of this study is to evaluate and compare, retrospectively, the outcome of two different periodontal regeneration procedures in patients suffering from aggressive periodontitis (AgP). Twenty-eight patients were diagnosed with AgP, suffering from several intra-bony defects (IBD); that were treated by one of two periodontal regeneration techniques randomly assigned to each patient: a. guided tissue regeneration (GTR) or b. an application of extracted enamel matrix derivatives (EMD) combined with demineralized bone xenograft particles (DBX). Probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession were recorded. Pre-treatment and follow-up (up to 10 years from the surgery) recordings were analyzed statistically within and between groups. A significant reduction was shown at time on PPD and CAL values, however, not between subject groups. CAL values decreased in all sites. At the EMD group (44 sites), CAL gain was 1.92 mm (±1.68) from pre-treatment to follow-up (p < 0.001) and at the GTR group (12 sites) CAL gain of 2.27 (±1.82) mm. In conclusion, 1–10 years observations have shown that surgical treatment of AgP patients by either GTR or by application of EMD/DBX results in similar successful clinical results.


2019 ◽  
Author(s):  
Xin Zhang ◽  
Zixuan Hu ◽  
Xuesong Zhu ◽  
Wenjie Li ◽  
Jun Chen

Abstract Background: Mechanical plaque removal has been commonly accepted to be the basis for periodontal treatment. This study aims to compare the effectiveness of ultrasonic and manual subgingival scaling at different initial probing pocket depths (PPD) in periodontal treatment. Methods: Public databases were searched. Weighted mean differences in PPD and clinical attachment loss (CAL) reduction were estimated by random effects model. Bleeding on probing (BOP), gingival recession (GR), and post-scaling residual dental calculus were analyzed by comparing the results of each study. Results: Ten randomized controlled trials were included out of 1,434 identified. Selected outcomes were PPD and CAL. Initial PPD and follow-up periods formed subgroups. For 3-month follow-up: (1) too few shallow initial pocket studies available to draw a conclusion; (2) the heterogeneity of medium depth studies was so high that could not be merged to draw a conclusion; (3) deep pocket studies showed no statistical differences in PPD and CAL reduction between ultrasonic and manual groups. For 6-month follow-up: (1) too few shallow initial PPD studies to draw a conclusion; (2) at medium pocket depth, PPD reduction showed manual subgingival scaling better than ultrasound. No statistical differences were observed in CAL reduction between the two approaches; (3) for deep initial PPD studies, both PPD and CAL reduction showed manual subgingival scaling better. GR results indicated no statistical differences at medium and deep initial pocket studies between the two methods. BOP results showed more reduction at deep pocket depths with manual subgingival scaling. No conclusion could be drawn about residual dental calculus. Conclusion: When initial probing pocket depth was 4-6mm, PPD reduction proved manual scaling superior to ultrasonic subgingival scaling, but CAL and GR results showed no statistical differences between the two means. When initial probing pocket depth was ≥6mm, PPD, CAL and BOP reductions suggested that manual subgingival scaling was superior to ultrasonic subgingival scaling, but GR results showed no statistical differences. No conclusion could be drawn about residual dental calculus.


2016 ◽  
Vol 69 (6) ◽  
pp. 631-637
Author(s):  
Beata Wyrębek ◽  
Renata Górska ◽  
Dorota Cudziło ◽  
Paweł Plakwicz

Aim of the study. To evaluate differences in periodontal parameters and oral hygiene between cleft and control sides in growing patients with unilateral cleft. Materials and Methods: 15 patients, aged 10 to 18 years, with unilateral cleft lip and palate. Evaluation of probing pocket depth (PPD), clinical attachment level (CAL), gingival recession (REC), vestibule depth (VD), keratinized gingiva (KG), presence of plaque (PCR) and bleeding on probing (BoP) for eight maxillary anterior teeth were performed. Types of fraena and mucosa deformities were also evaluated. Results. Significant differences for PD (but not for CAL) were found only at some surfaces of lateral incisors and canines. Keratinized gingiva was significantly narrower at lateral incisors, canines and first premolars on the cleft side (mean values were: 2.8 mm and 5.4 mm for lateral incisors, 2.7 mm and 3.9 mm for canines, 3.1 mm and 4.7 mm for first premolars, respectively for the affected and the control side). Significantly shallower vestibule at central and lateral incisors was found at some group of teeth (mean values were: 7.0 and 9.2 mm for central incisors, 8.6 and 11.6 mm for lateral incisors, respectively for the affected and control side). Due to tissue malformations it was difficult to assess the upper labial fraena. High scores were recorded for PCR and BoP both on the cleft and the control side. Conclusions. Malformations of soft tissues caused by cleft and previous surgical procedures negatively affected periodontal parameters on the cleft side. It is requisite to introduce periodontal assessment into comprehensive approach in children with clefts to control development of periodontal disease.


2017 ◽  
Vol 07 (01) ◽  
pp. 069-073
Author(s):  
Anahita Punj ◽  
Amitha Ramesh

AbstractGingival recession is defined as the apical migration of the gingival margin beyond the cementenamel junction (CEJ). This results in the exposure of tooth roots which is aesthetically unpleasing and can also result in tooth hypersensitivity. A number of surgical procedures have been used to obtain root coverage. The aim of the present article was to evaluate the coverage of labial gingival recession defects with coronally advanced flap procedure in two cases with labial gingival recession.Two male patients (32 year and 52 year old) were treated for root coverage with coronally advanced flap in maxillary right first molar (16), second premolar (15) and maxillary left incisor (22) and canine (23) region respectively.In both the cases, root coverage of the labial recession defects was observed.


2016 ◽  
Vol 6 ◽  
pp. 31-38
Author(s):  
Prashant K. Zaveri

Malocclusion superimposed with severe periodontitis may present a great challenge to clinicians while providing orthodontic treatment due the episodic and site-specific nature of the disease with risk of rapid tissue breakdown. However, orthodontic treatment in such situation may contribute significantly to the overall rehabilitation both functionally and esthetically. In this article, a case report outlines a combined periodontic-orthodontic management of compromised dentition. A 37-year-old female patient with significant medical history was treated for Class II Division 1 type of malocclusion associated with spaced upper and lower anterior teeth, deep overbite, and increased overjet, superimposed with chronic generalized periodontitis and bone loss. Treatment was completed using temporary anchorage devices assisted strategically applied force and modified tandem retraction biomechanics amidst management of acute inflammatory episodes during and mucogingival complication after treatment. Affected areas healed very well after post-orthodontic periodontal treatment with minimal pocket depth, and bleeding on probing, and a healthy zone of attached gingiva at the follow up visits. The orthodontic results lead to improvement in patient’s facial profile, lip posture, and correction of protrusion which addressed her main concern. One year follow-up shows good orthodontic and periodontic stability. The report highlights the importance of identifying “at risk” individuals and continuous monitoring of disease status during treatment. Despite all precautionary measures, a flare-up during the treatment can be anticipated.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Liza L. Ramenzoni ◽  
Deborah Hofer ◽  
Alex Solderer ◽  
Daniel Wiedemeier ◽  
Thomas Attin ◽  
...  

Abstract Background Pathologically elevated levels of matrix metalloproteinase-8 (MMP-8) and Lactoferrin in oral fluids have been associated with the presence of gingivitis/periodontitis. This study aimed to assess the origin of MMP-8 and Lactoferrin in periodontitis patients and to identify the degree to which conventional clinical parameters correlate with their presence. Methods A total of ten periodontitis and ten healthy patients were included in this study. Whole saliva (stimulated and unstimulated), parotid/sublingual glandular fluid and gingival crevicular fluid from pockets and sulci were tested for MMP-8 and Lactoferrin and protein concentrations were quantified using an ELISA assay. Clinical parameters were checked for potential associations with MMP-8 and Lactoferrin levels. Results Periodontal patients presented higher concentrations of MMP-8 and Lactoferrin in pockets than other sources (P = 0.03). Lactoferrin measurement was higher in the parotid compared to sublingual glandular fluid in periodontitis patients (P = 0.03). Increased probing pocket depth was positively correlated with high MMP-8 and Lactoferrin levels. Conclusions Periodontal pockets appear to be the major source of active matrix metalloproteinase and Lactoferrin, which also may also enter the oral cavity through the salivary glands. Since clinically healthy sites in periodontitis patients also had elevated biomarker levels, gingival crevicular fluid biomarker testing may be more predictive of future tissue breakdown than conventional clinical parameters.


2015 ◽  
Vol 26 (1) ◽  
pp. 39-43 ◽  
Author(s):  
Bruno César de Vasconcelos Gurgel ◽  
Carlos Roberto Batista de Morais ◽  
Pedro Carlos da Rocha-Neto ◽  
Euler Maciel Dantas ◽  
Leão Pereira Pinto ◽  
...  

Phenytoin-induced gingival overgrowth (PIGO) is a common complication of the continuous use of medications. This paper presents a case of PIGO hindering oral function and compromising oral hygiene and aesthetics, which was treated with a combination of nonsurgical and surgical periodontal therapies. A 39-year-old male patient was referred for dental treatment with several complaints, especially upper and lower gingival overgrowth that hindered speech and swallowing. Generalized deep probing pockets and bone loss were detected. Diagnosis of gingival overgrowth associated with phenytoin and chronic periodontitis was established. The treatment plan consisted of conservative therapy with education on oral health, motivation and meticulous oral hygiene instruction in combination with scaling and root planing. During the revaluation period, a marked reduction in the clinical parameters was noted, particularly probing pocket depth reduction. Surgical therapy for removal of gingival overgrowth was also performed to achieve pocket reduction. Supportive periodontal therapy was proposed and the patient is currently under follow-up for 4 years. Management of PIGO may be obtained by the use of periodontal procedures combined with good oral hygiene and periodontal supportive care.


2015 ◽  
Vol 03 (03) ◽  
pp. 179-184
Author(s):  
Yash Dev ◽  
Nitin Khuller ◽  
Preetinder Singh ◽  
Prabhjot Kaur ◽  
Yashbir Raghav ◽  
...  

AbstractThe aim of this clinical trial was to evaluate the clinical effectiveness of a collagen barrier along with an alloplastic bone graft in the treatment of gingival recession defects. Two patients having Miller’s Class I or Class II recession defects participated in the study. One was treated with a collagen membrane covered by a coronally positioned flap. Second patient also had bone graft placed beneath the membrane. Clinical parameters were recorded. Patients were followed postoperatively and healing was evaluated at 1, 3 and 6 months, with recession depth as the primary criteria for assessment. This case report revealed a favorable tissue response to bone graft and collagen membrane from both clinical and esthetic point of view in the treatment of gingival recession. Root coverage tended to be better with the addition of bone graft.


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