Treatment of gingival recession with coronally advanced flap combined with connective tissue graft/alloderm: A systematic review

2014 ◽  
Vol 4 (2) ◽  
pp. 70 ◽  
Author(s):  
GunjiganurVemanaradhya Gayathri ◽  
Sohini Choudary ◽  
N Bharath ◽  
E Shilpa ◽  
DhoomSingh Mehta
Keyword(s):  
Systematic Review ◽  
Connective Tissue ◽  
Gingival Recession ◽  
Coronally Advanced Flap ◽  
Connective Tissue Graft ◽  
Tissue Graft

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.

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 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.

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