Analysis of root coverage esthetic score in patients treated for gingival recession: An interexaminer reliability

Objective: This study aims to evaluate periodontal clinical conditions after treatment for gingival recession (GR) using subepithelial connective tissue graft (SCTG) and acellular dermal matrix (ADM).Methods: Ten patients with Miller’s Class I and II recessions that had been treated with SCTG or ADM at the Periodontics Outpatient Department at Universitas Indonesia were selected for this study. The pre-operative data for GR, clinical attachment levels (CAL), and attached gingiva (AG) were retrieved from the patients’ medical records. The patients were recalled and the post-operative data were recorded.Results: The application of SCTG and ADM yields significant changes to GR, CAL, and AG levels. A comparison of two groups at the post-operative assessment stage showed no statistically significant differences, in terms of GR, CAL, and AG.Conclusion: SCTG and ADM yield similar outcomes in the treatment of GR. As such, ADM may be suggested as an alternative to SCTG for root coverage.

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Evaluation of The Clinical Efficacy of Collagen Membrane In Combination with Bone Grafts in the Treatment of Miller’s Class I /II Marginal Tissue Recession: A Case Report

Dental Journal of Advance Studies ◽

10.1055/s-0038-1672035 ◽

2015 ◽

Vol 03 (03) ◽

pp. 179-184

Author(s):

Yash Dev ◽

Nitin Khuller ◽

Preetinder Singh ◽

Prabhjot Kaur ◽

Yashbir Raghav ◽

...

Keyword(s):

Case Report ◽

Bone Graft ◽

Clinical Effectiveness ◽

Gingival Recession ◽

Point Of View ◽

Tissue Response ◽

Class I ◽

Collagen Membrane ◽

Clinical Parameters ◽

Root Coverage

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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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

Journal of Advanced Periodontology & Implant Dentistry ◽

10.15171/japid.2019.003 ◽

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.

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Root Coverage with Coronally Advanced Flap with Connective Tissue Graft: Literature Review and Case Report

Odovtos - International Journal of Dental Sciences ◽

10.15517/ijds.v19i2.28745 ◽

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.

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rhPDGF Mediated Root Coverage Procedure Using Coronally Advanced Flap in Treatment of Multiple Recession Defects: A Case Report

Dental Journal of Advance Studies ◽

10.1055/s-0038-1672047 ◽

2016 ◽

Vol 04 (01) ◽

pp. 059-064

Author(s):

Preetinder Singh ◽

Yash Dev ◽

Khuller Nitin ◽

Anahita Singh ◽

Prabhjot Kaur ◽

...

Keyword(s):

Case Report ◽

Primary Outcome ◽

Gingival Recession ◽

Root Surface ◽

Primary Outcome Measure ◽

Tissue Response ◽

Root Coverage ◽

Coronally Advanced Flap ◽

Lower Jaw ◽

Points Of View

AbstractGingival recession has been defined as the term used to characterize the apical shift of the marginal gingiva from its normal position on the crown of the tooth to levels on the root surface beyond the cemento-enamel junction (CEJ). Numerous techniques have been developed for treatment of these defects including rotational and advanced gingival flaps, soft-tissue grafting procedures with autogenous and allograft materials. This paper illustrates a case report of 42-years-old male patient with a chief complaint of thermal root sensitivity in relation with front teeth of lower jaw and describes a technique to coronally advance the flap in combination with recombinant human platelet-derived growth factor-BB (rhPDGF-BB) (GEM 21S®) to treat multiple gingival recession defects. Patient was followed postoperatively, and healing was evaluated at 1, 3 and 6 months, with recession depth as the primary outcome measure. This case report revealed a favourable tissue response to GEM 21S® from both clinical and aesthetic points of view showing excellent plastic surgery results for gingiva.

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Management of Multiple Recession simultaneously with Modified Coronally Advanced Flap

Journal of Nepalese Society of Periodontology and Oral Implantology ◽

10.3126/jnspoi.v1i2.23567 ◽

2017 ◽

Vol 1 (2) ◽

pp. 81-83

Author(s):

Harish Kumar Shah ◽

Shashi Kant Chaudhary ◽

Khushboo Goel ◽

Sajeev Shrestha

Keyword(s):

Prognostic Factors ◽

Gingival Recession ◽

Class I ◽

Root Coverage ◽

Periodontal Health ◽

Aesthetic Result ◽

Coronally Advanced Flap ◽

Flap Procedure ◽

The Aesthetic

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.

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Platelet Rich Fibrin as Wound Coverage of Donor Site in Free Gingival Graft

Journal of Nepalese Society of Periodontology and Oral Implantology ◽

10.3126/jnspoi.v2i1.23607 ◽

2018 ◽

Vol 2 (1) ◽

pp. 26-29

Author(s):

Shweta Agrawal ◽

Pramod Kumar Koirala ◽

Shalini Pradhan ◽

Ranjita Shrestha Gorkhali

Keyword(s):

Wound Healing ◽

Pain Perception ◽

Donor Site ◽

Gingival Recession ◽

Root Coverage ◽

Wound Coverage ◽

Platelet Rich Fibrin ◽

Free Gingival Graft ◽

Keratinized Tissue ◽

Gingival Graft

Free gingival graft is one of the technique used for root coverage so as to increase the inadequate keratinized tissue. The donor tissue is most frequently taken from the palate and generally the donor site is not covered or protected. Platelet rich fibrin is one of the good option for the wound coverage of donor site after free gingival graft so as to reduce the pain perception to patient and faster wound healing. The case report includes two cases with gingival recession, treated on the same day with free gingival graft with the use of platelet rich fibrin in the donor site in case 1 and without platelet rich fibrin in case 2 respectively which were compared for pain perception and wound healing postoperatively at 24 hours, 3 days, 5 days, 7 days and 14 days. There was less pain perception and discomfort in the donor site with the use of platelet rich fibrin and enhanced healing compared to donor site without platelet rich fibrin.

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Periodontal biotype: anatomic features and association with surrounding tissue

Medical Journal of the Russian Federation ◽

10.18821/0869-2106-2020-26-2-114-118 ◽

2020 ◽

Vol 26 (2) ◽

pp. 114-118

Author(s):

I. S. Kopetskiy ◽

L. V. Pobozhieva ◽

Yu. V. Shevelyuk ◽

A. I. Kopetskaya

Keyword(s):

Periodontal Diseases ◽

Gingival Recession ◽

Response To Treatment ◽

Surrounding Tissue ◽

Root Coverage ◽

Gingival Thickness ◽

Keratinized Tissue ◽

High Prevalence ◽

Periodontal Biotype ◽

Gingival Biotype

The high prevalence of periodontal diseases, up to 90%, is an important issue in medicine. The periodontal biotype is one of the most important parameters that determine the course and prognosis of periodontal diseases. Gingival thickness, keratinized tissue, and bone morphology are the main characteristics of the periodontal biotype. This article presents a review of the literature on the characteristics of periodontal biotypes, their response to treatment, and treatment prognosis. A search of electronic databases (Medline, EMBASE, CyberLeninka, Elibrary, and RINC) was performed for the literature review. The article also presents studies about relationships among periodontal biotype, recession, and malocclusion. The thin biotype is a predictive factor of gingival recession. Recessions are characterized by apical migration of marginal gingiva and defects in root coverage. Gingival recession may result from orthodontic movement of teeth, particularly among patients with the thin gingival biotype. The thin and thick biotypes respond differently to inflammation, restorative and surgical effects, and parafunctional habits. A gingival thickness greater than 2 mm can be categorized as the thick biotype and less than 1,5 mm as the thin biotype. Gingival thickness can affect the results of restorative therapy and root coverage procedures. It is necessary to determine the gingival biotype before initiating treatment. Special care must be taken when planning treatment for cases with a thin biotype.

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