scholarly journals Root Coverage in Miller Classes I and II associated with Subepithelial Connective Tissue Graft: A comparative Clinical Trial of Two Techniques

2017 ◽  
Vol 8 (4) ◽  
pp. 248-254
Author(s):  
Vitor J Spada ◽  
Patricia O Nassar ◽  
Nahana Cardoso ◽  
Khadidjia MB Caldato ◽  
Jordana H Pandini ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Test Group ◽  
Gingival Recession ◽  
Control Group ◽  
Root Coverage ◽  
Clinical Attachment Level ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Subepithelial Connective Tissue Graft ◽  
Attachment Level

ABSTRACT Introduction Gingival recession is characterized by apical positioning of the gingival side in relation to the cementoenamel junction. Thus, this study aimed at evaluating the effectiveness of two surgical techniques for root coverage in patients with gingival recession of Miller class I or II. Materials and methods A total of 13 patients were selected, from the age group of 20 to 50 years, with bilateral gingival recession Miller class I or II, totaling 34 recessions. When the basic periodontal treatment was accomplished, every recession was included in one of both selected groups according to the surgical technique: Control group—Subepithelial connective tissue graft associated with coronally positioned flap technique and test group—Subepithelial connective tissue graft associated with the modified envelope technique. Patients were evaluated for 180 days, and the periodontal parameters were analyzed in 0, 90, and 180 days. Results The results showed that both surgeries were effective since they kept probe depths with periodontal health and clinical attachment gain (p < 0.05) in both groups, up from 90 days. The reduction was kept for 180 days, mainly for the control group that showed a clinical attachment gain that was still statistically significant at 180 days (p < 0.05). Regarding the root coverage, the control group showed a 90.2% of coverage while the test group showed 89.5%. Conclusion Thus, it can be concluded that both techniques, after 180 days, were effective for the health of periodontal tissues; however, a greater emphasis can be observed on the subepithelial connective tissue graft-associated coronally positioned flap technique because this technique demonstrated a greater significant gain in the clinical attachment level. Clinical significance The subepithelial connective tissue graft is used for gaining the clinical attachment level in the root coverage of patients with gingival recession Miller classes I and II. How to cite this article Spada VJ, Nassar PO, Cardoso N, Caldato KMB, Pandini JH, Randon DM, Nassar CA. Root Coverage in Miller Classes I and II associated with Subepithelial Connective Tissue Graft: A comparative Clinical Trial of Two Techniques. World J Dent 2017;8(4):248-254.

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 Effect of Root Surface Biomodification on Multiple Recession Coverage with Modified Coronally Advanced Tunnel Technique and Subepithelial Connective Tissue Graft: A Retrospective Analysis

Gels ◽  
2022 ◽  
Vol 8 (1) ◽  
pp. 31
Author(s):  
Bartłomiej Górski ◽  
Marcin Szerszeń
Keyword(s):  
Connective Tissue ◽  
Root Surface ◽  
Enamel Matrix Derivative ◽  
Root Coverage ◽  
Clinical Attachment Level ◽  
Gingival Thickness ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Subepithelial Connective Tissue Graft ◽  
Attachment Level

To improve treatment efficacy of gingival recessions (GR), chemical preparation of the exposed root surface was advocated. The aim of this study was to compare the additional influence of root biomodifications with 24% ethylenediaminetetraacetic acid (EDTA) alone or with enamel matrix derivative (EMD) on the 12 month outcomes of modified coronally advanced tunnel (MCAT) with subepithelial connective tissue graft in the treatment of multiple GR. Average root coverage (ARC), complete root coverage (CRC), reduction in GR, reduction in recession width (RW), gain in clinical attachment level (CAL), increase in gingival thickness (GT), increase in keratinized tissue width (KTW) and changes in root coverage esthetic score (RES) were evaluated. A total of 60 patients with 215 GR were enrolled. In 70, GR root surfaces were treated with EDTA + EMD, in other 72, with EDTA, while in the remaining 73 saline solution was applied. ARC was 94%, 89%, and 91% in the EDTA + EMD, the EDTA and the saline groups, respectively (p = 0.8871). Gains in clinical attachment level (CAL; 2.1 ± 1.1 mm) and RES values (9.6 ± 0.9) were significantly higher in the EDTA + EMD group, when compared with two other groups. The differences between other preoperative and postoperative parameters showed statistical significance only within but not between groups. MCAT outcomes may benefit from adjunctive use of EDTA + EMD regarding 12 month CAL gain and professionally assessed esthetics using RES following treatment of GR.

scholarly journals Comparison of acellular dermal matrix allograft (ADMA) and a subepithelial connective tissue graft (SCTG) for the treatment of gingival recession

2020 ◽  
Vol 12 (1) ◽  
pp. 11-17
Author(s):  
Niloofar Jenabian ◽  
Mohadese Yazdanpanahbahabadi ◽  
Parya Haghpanah Aski ◽  
Ali Bijani
Keyword(s):  
Connective Tissue ◽  
Test Group ◽  
Acellular Dermal Matrix ◽  
Gingival Recession ◽  
Root Coverage ◽  
Dermal Matrix ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Subepithelial Connective Tissue Graft ◽  
Acellular Dermal

Background. This study aimed to evaluate the effect of acellular dermal matrix allograft (ADMA) for the treatment of gingival recession as a substitute for subepithelial connective tissue graft (SCTG). Methods. In this controlled clinical trial, 18 teeth were selected in nine subjects with bilateral gingival recession. One side was treated with SCTG and a coronally displaced flap as the control group, and the other side was treated with ADMA and a coronally displaced flap as the test group. Probing pocket depth (PPD), clinical attachment level, vertical recession depth, recession width, gingival thickness, keratinized tissue width, and the root coverage percentage were measured before the surgery and at 1-, 3-, and 6-month postoperative intervals. The healing index, pain index, and patient satisfaction were also investigated. The data were analyzed with a general linear model (GLM) repeated measures and paired t-test. Results. All the parameters improved except for PPD; however, a comparison between the groups did not reveal statistically significant differences. Only root coverage percentage and pain index were significantly lower in the test group. The average percentage of root coverage in the control and test groups were 82.01±16.62% and 64.44±9.4%, respectively. Conclusion. Both methods resulted in improvements in the clinical results. However, the use of the ADMA led to less pain and root coverage in comparison with the SCTG method.

scholarly journals EFFECT OF SMOKING ON THE PERIODONTAL MICROSURGERY TECHNIQUE ON THE TREATMENT OF GINGIVAL RECESSION

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Renata De Araújo Barbosa ◽  
Mônica Dourado ◽  
Maria Cecília Azoubel ◽  
Roberta Santos Tunes ◽  
Érica Del Peloso Ribeiro ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Gingival Recession ◽  
Root Coverage ◽  
Average Percentage ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Keratinized Tissue ◽  
Probing Depth ◽  
Subepithelial Connective Tissue Graft ◽  
Attachment Level

This paper aims to evaluate the effects of smoking on periodontal microsurgery technique using the subepithelial connective tissue graft (SCTG) for treatment of gingival recession on smokers. 14 patients nonsmokers and 12 smokers were selected, presenting Miller’s Class I and II gingival recession ≥ 2.0 mm. For both groups, the subepithelial connective tissue graft was used with the aid of a surgical microscope. The clinical parameters of width and height of the gingival recession, height and thickness of keratinized tissue, probing depth and clinical attachment level were evaluated before and six months after surgery. At the end of the study, there were obtained an average percentage of 96.66% of root coverage on nonsmokers and 82.49% on smokers (p=0.03). Complete root coverage was observed in 78,57% and 50% of patients, respectively. Therapy can benefit both groups, but smokers have less favorable outcomes to root coverage with periodontal microsurgery using the SCTG.

scholarly journals ROOT COVERAGE USING THE SUBEPITHELIAL CONNECTIVE TISSUE GRAFT OR THE ACELLULAR DERMAL MATRIX FOR THE TREATMENT OF GINGIVAL RECESSION: A CLINICAL STUDY

2018 ◽  
Vol 9 ◽  
pp. 20
Author(s):  
Shula Zuleika Sumana ◽  
Sri Lelyati C Masulili ◽  
Robert Lessang
Keyword(s):  
Connective Tissue ◽  
Acellular Dermal Matrix ◽  
Gingival Recession ◽  
Root Coverage ◽  
Dermal Matrix ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Operative Data ◽  
Subepithelial Connective Tissue Graft ◽  
Acellular Dermal

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.

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 Free Gingival Autograft and Subepithelial Connective Tissue Graft for the Treatment of Gingival Recession: A Brief Review and Report of Three Cases

2016 ◽  
Vol 6 (3) ◽  
pp. 225-232
Author(s):  
Seema Yadav ◽  
Jaishree A Rijhwani ◽  
Vineet V Kini
Keyword(s):  
Connective Tissue ◽  
Gingival Recession ◽  
Root Coverage ◽  
Recipient Site ◽  
Advantages And Disadvantages ◽  
Free Gingival Graft ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Attached Gingiva ◽  
Subepithelial Connective Tissue Graft

ABSTRACT Gingival recession is the migration of the free gingival margin apical to the cementoenamel junction. There are various factors contributing toward gingival recession apart from periodontal disease that include faulty tooth brushing, tooth position or malaligned teeth, high muscle or frenal attachment, alveolar bone dehiscence, orthodontic forces, and iatrogenic factors leading to problems of esthetics, hypersensitivity, and root caries. Several periodontal plastic surgical techniques have been introduced in the previous literature aiming to correct marginal tissue recessions, the predictability of which depends upon careful evaluation of the defect type, presence of attached gingiva, keratinized tissue width, and presence of single or multiple gingival recessions. The use of free gingival graft (FGG) and subepithelial connective tissue graft (SCTG) in root coverage is indicated for the treatment of single or multiple gingival recessions. Although both FGGs and SCTGs provide significant reduction in recession depth and clinical attachment gain for Miller's Class I and II gingival recession defects, SCTG seems to offer root coverage with a better color match between donor and recipient site tissue rendering better esthetics. Considering the advantages and disadvantages of FGG and SCTG in root coverage procedures, the following case reports describe the clinical results using FGG by Miller's technique, and using SCTGs by technique of Langer and Langer, and Zabalegui tunnel technique for the treatment of gingival recession. How to cite this article Rijhwani JA, Kini VV, Pereira R, Yadav S. Free Gingival Autograft and Subepithelial Connective Tissue Graft for the Treatment of Gingival Recession: A Brief Review and Report of Three Cases. J Contemp Dent 2016;6(3):225-232.

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.

scholarly journals Esthetic Root Coverage with Double Papillary Subepithelial Connective Tissue Graft: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Ramesh Babu Mutthineni ◽  
Ram Babu Dudala ◽  
Arpita Ramisetty
Keyword(s):  
Connective Tissue ◽  
Tissue Regeneration ◽  
Gingival Recession ◽  
Surgical Approaches ◽  
Root Coverage ◽  
Hard Tissue ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Subepithelial Connective Tissue Graft ◽  
Tissue Grafts

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.

Sign in / Sign up

Export Citation Format

Share Document