The Subepithelial Connective Tissue Graft: Part 1. Patient Selection and Surgical Techniques

2005 ◽  
Vol 6 (1) ◽  
pp. 146-162 ◽  
Author(s):  
Lawrence G. Breault ◽  
Lemuel L. Covington ◽  
Barry G. Bishop ◽  
Constance L. Sedon

Abstract Periodontal mucogingival techniques continually evolve. This provides the patient more treatment alternatives for common problems such as gingival recession. General practitioners should be familiar with these techniques in order to identify patients who might benefit from them. Currently, subepithelial connective tissue grafts (SCTG) remain the most reliable techniques used to cover denuded root surfaces. This paper reviews patient selection and the numerous surgical approaches for subepithelial connective tissue grafting. Citation Sedon CL, Breault LG, Covington LL, Bishop BG. The Subepithelial Connective Tissue Graft: Part I. Patient Selection and Surgical Techniques. J Contemp Dent Pract 2005 February;(6)1:146-162.

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Ramesh Babu Mutthineni ◽  
Ram Babu Dudala ◽  
Arpita Ramisetty

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.


Author(s):  
Anita Mehta

The Gingival recession is considered a multi-factorial. The etiology may be an anatomically vulnerable area, faulty tooth brushing, high frenum attachment. In cases where there is progressive recession, aesthetics concern or increasing dentinal hypersensitivity, we can do recession coverage. Depending upon the presence or absence of adequate keratinized tissue we can choose the technique. In case of adequate width of keratinized tissue, usually we can do displaced flap and in case where there is inadequate width, we can do gingival grafting.


2018 ◽  
Vol 9 ◽  
pp. 20
Author(s):  
Shula Zuleika Sumana ◽  
Sri Lelyati C Masulili ◽  
Robert Lessang

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.


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

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.


2019 ◽  
Vol 11 (1) ◽  
pp. 12-20
Author(s):  
Saeed Sadat Mansouri ◽  
Omid Moghaddas ◽  
Narjes Torabi ◽  
Katayoun Ghafari

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.


2019 ◽  
Vol 45 (6) ◽  
pp. 483-485
Author(s):  
Joshua Segal ◽  
Monika Patel ◽  
Henry Woo ◽  
Rachel Pruitt

Subepithelial gingival connective tissue grafts are a common surgical procedure performed in periodontal and implant surgery. This versatile procedure has many indications including tooth root coverage, thickening of gingiva, and improvement of the quality of the crestal gingiva. Several techniques have been described for graft harvest from the palate. Reported complications from these techniques include pain, inflammation, bleeding, flap necrosis, and infection in the donor site. We report a previously unpublished complication following subepithelial gingival connective tissue graft from the palate: pseudoaneurysm of the greater palatine vessel.


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