scholarly journals Double Papilla Graft with Amnion Membrane for Root Coverage of Isolated Recession

2016 ◽  
Vol 7 (4) ◽  
pp. 213-216
Author(s):  
Ruchi Srivastava ◽  
Zeba R Siddiqui ◽  
Rajesh Jhingran ◽  
Vivek K Bains

ABSTRACT Gingival recession is one of the most common soft tissue problems, especially when it hinders the esthetics of a patient. Gingival recession can further lead to root caries, sensitivity, and difficulty in plaque control. Moreover, exposed roots are prone to abrasion and erosion. Periodontal plastic surgery is one of the emerging fields, which helps to meet such soft tissue problems. Currently, a variety of techniques are being used for root coverage, like pedicle grafts, coronally advanced flap, free mucosal graft, epithelial connective tissue graft, guided tissue regeneration, and acellular dermal matrix. This article highlights a case that was successfully managed by double papilla graft technique in combination with amnion membrane for root coverage of Miller class II recession defect in the mandibular canine region. In this technique, the soft tissues adjacent to the recession area were positioned over the recession defect. The main advantage of this technique is that the flap remains attached at its base so that it retains its own blood supply during transfer to a new position. It also preserves the interdental papilla, thus preserving the gingival height. As an alternative to the epithelial connective tissue graft, amnion membrane has the advantage of no invasive palatal wound, regenerative potential, and improved esthetic results. This procedure is highly sensitive and had predictable results, with a clinically significant amount of root coverage. How to cite this article Srivastava R, Siddiqui ZR, Jhingran R, Bains VK. Double Papilla Graft with Amnion Membrane for Root Coverage of Isolated Recession. World J Dent 2016;7(4):213-216.

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.


2017 ◽  
Vol 19 (2) ◽  
pp. 25
Author(s):  
Francisco J. Jiménez Bolaños DDS ◽  
Marcelino Fernández Murillo

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.


2020 ◽  
Vol 13 (12) ◽  
pp. e238816
Author(s):  
Igor Ashurko ◽  
Eduard Levonian ◽  
Ilia Dementev ◽  
Svetlana Tarasenko

The application of free connective tissue graft (CTG) is the gold standard in the treatment of gingival recession in the area of teeth and implants. The aim of this case report is to demonstrate a possible mucosal overgrowth complication in the soft tissue grafting area. A 24-year-old patient underwent the treatment of gingival recession in the tooth 2.3 region by an envelope technique using a free CTG from the hard palate region. Seven years after the surgery, a mucosal overgrowth was observed, which developed asymptomatically and did not cause any problems to the patient.


2020 ◽  
Vol 9 (8) ◽  
pp. 2641
Author(s):  
Souheil Salem ◽  
Leila Salhi ◽  
Laurence Seidel ◽  
Geoffrey Lecloux ◽  
Eric Rompen ◽  
...  

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.


2020 ◽  
Author(s):  
Yalin Zhan ◽  
Miaozhen Wang ◽  
Xiaojing Cao ◽  
Feng Liu

Abstract BackgroundAmong all mucogingival deformities, gingival recession is one of the most prevalent conditions that demand surgical correction. Accordingly, root coverage procedures are essential parts of plastic periodontal surgeries. It is undeniable that autogenous tissue grafts remain the gold standard for root coverage procedures. Substantial evidences have identified that the connective tissue graft (CTG) combined with coronally advanced flap (CAF) achieves favorable root coverage of recession. Nevertheless, there are some noticeable disadvantages of harvesting autogenous tissue, such as postoperative bleeding, pain, or discomfort at the donor site, restricted tissue supply, increased morbidity, and longer operative duration. In order to overcome the drawbacks of autogenous tissue harvesting, several non-vital substitutes have been produced as alternative options for replacing connective tissue graft. Acellular dermal matrix (ADM) is an allograft derived from human skin, which has been used extensively in various areas of dental practice over the last two decades. ADM exhibits undamaged collagen and elastin matrices that has been used as a substitute for connective tissue for root coverage procedures. Although its clinical efficacy has been discussed in several reviews, conclusions about the application of this material are still unclear and controversial. Moreover, the level of evidence on the clinical outcomes and patient-reported outcomes relevant to ADM graft (ADMG) is low. Therefore, the objective of this split-mouth; randomized, controlled, clinical study is to compare the long-term clinical efficacy of ADMG combination with CAF on root coverage, aesthetics and patient satisfaction with CTG combination with CAF for gingival recession with thin periodontal phenotype, hoping to provide some reference to dentists.Methods/designForty participants with bilateral Miller Class I/II gingival recession randomly received ADMG (test group) on one side and CTG (control group) on the contralateral side in conjunction with CAF. Gingival recession depth (GRD), gingival recession width (GRW), keratinized tissue width (KTW) are measured at baseline, 2, 4, 12, 24, 48 and 96 weeks. Mean root coverage (MRC), complete root coverage (CRC), root coverage aesthetic score (RES), color change (∆E), and patient satisfaction are assessed in postoperative follow-up.DiscussionCAF combined with CTG has been shown as a predictable technique in root coverage. At present, there is limited long-term data evaluating ADM on root coverage, aesthetics and patient satisfaction for the treatment of gingival recession with thin periodontal phenotype. The result of this split-mouth randomized controlled clinical studies is performed to evaluate the long-time efficacy of ADM, particularly when compared to the “gold standard” (CTG), contributing to an advanced treatment strategy of gingival recession with ideal clinical outcome. Trial registrationInternational Clinical Trials Registry Platform (ICTRP), ID: ChiCTR2000033230. Registered on 25 May 2020, http://www.chictr.org.cn/showproj.aspx?proj=54052


2022 ◽  
Vol 11 (1) ◽  
pp. 235
Author(s):  
Evgeny Weinberg ◽  
Roni Kolerman ◽  
Lazar Kats ◽  
Omer Cohen ◽  
Daya Masri ◽  
...  

(1) Background: To assess the clinical outcome of coronally advanced flap combined with connective tissue graft for the treatment of orthodontic-associated Miller Class III gingival recession of the lower incisors. (2) Methods: This study included 15 patients who had undergone orthodontic treatment prior to development of recession. Measurements of recession depth, recession width, probing depth, and width of keratinized tissue were performed clinically immediately before surgery and after one year. In addition, digital measurements of recession depth, recession width, and root coverage esthetic score were performed on intraoral photographs. (3) Results: Significant reduction was observed for probing depth, recession depth, and recession width at one year, with significant increase in width of keratinized tissue. Mean root coverage was 83 ± 24% for recession depth, while complete root coverage was achieved in 10 out of 21 recessions (48%). The average root coverage esthetic score at 12 months was 7.1 ± 2.6. An interaction was found between initial recession depth and mean root coverage. (4) Conclusions: Within the limitations of this study, our results confirm that combination of coronally advanced flap and connective tissue graft is effective in reducing post-orthodontic Miller Class III recessions of the mandibular incisors, even when the correction of the tooth malposition, is unattainable.


2021 ◽  
Author(s):  
Evgeny Weinberg ◽  
Roni Kolerman ◽  
Omer Cohen ◽  
Alon Sebaoun ◽  
Gil Slutzkey

Abstract Aims To assess the clinical outcome (after one year) of coronally advanced flap combined with connective tissue graft for the treatment of orthodontic-associated Miller Class III gingival recession of the lower incisors. Materials and methods This study included 15 patients who had undergone orthodontic treatment prior to development of recession. Measurements of recession depth, recession width, probing depth, and width of keratinized tissue were performed clinically immediately before surgery and after one year. In addition, digital measurements of recession depth, recession width, and root coverage esthetic score were performed on intraoral photographs. Results Significant reduction was observed for probing depth, recession depth, and recession width at one year, with significant increase in width of keratinized tissue. Mean root coverage was 83 ± 24% for recession depth, while complete root coverage was achieved in 10 out of 21 recessions (48%). The average root coverage esthetic score at 12 months was 7.1 ± 2.6. An interaction was found between initial recession depth and mean root coverage. Conclusions Within the limitations of this study, our results confirm that combination of coronally advanced flap and connective tissue graft is effective in reducing post-orthodontic Miller Class III recessions of the mandibular incisors with a concomitant increase in width of keratinized tissue. Clinical Relevance These findings suggest that combination of coronally advanced flap with connective tissue graft may significantly improve post-orthodontic Miller Class III recessions of the mandibular incisors, even when the correction of the tooth malposition is unattainable.


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