Application of an active oxygen (blue®m) with free connective graft technique for root coverage – a case report

Jeferson Luis De Oliveira Stroparo,Carmen Lucia Mueller Storrer,Suyany Gabriely Weiss,Tatiana Miranda Deliberador

doi:10.33448/rsd-v10i5.15468

Jeferson Luis De Oliveira Stroparo, Carmen Lucia Mueller Storrer + Show 2 more

Open Access

https://doi.org/10.33448/rsd-v10i5.15468

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Abstract

Gingival recession occurs due to the migration of the gingiva in the apical direction, leading to compromising local aesthetics and root hypersensitivity. Connective tissue graft is the gold standard treatment in these cases improving both functional and aesthetics aspects.The purpose of this case is to report root coverage using the free connective tissue graftingtechnique (CTG) associated with topical application of active oxygen oral gel and mouthwash (blue®m). A 27-year-old female sought care with the main complaint of root hypersensitivity and the presence of gingival recession in the anterior region of the mandible. Clinical examination revealed the presence of type 1 gingival recession in the left mandibular central incisor. The treatment of choice was a modified graft (free connective graft). The graft and recipient bed received applications of blue®m oral gel. The patient was instructed to use blue®m mouthwash and blue®m oral gel after the surgery for 10 days. At 60 days, the patient showed satisfactory healing in the area of the free CTG, with gain of keratinized tissue and partial covering of the gingival recession. Free CTG with the support of the gel and the mouthwash with active oxygen release makes the technique viable, preventing graft necrosis and achieving root coverage and keratinized tissue.

Highlights

Gingival recession is defined as the exposure of the root of the dental element in the oral environment, due to the migration of the gingiva in the apical direction. [1]When this occurs, some pathologies can settle in the patient, ranging from the risk of caries, erosion, root hypersensitivity and lack of esthetics (Zucchelli & Sanctis 2000; Zucchelli et al, 2011; Storrer et al, 2019; Fernandes et al, 2021)
The new classification of gingival recessions based on the measurement of interdental clinical insertion is divided into: Type 1 recession (RT1), which has gingival recession without loss of interproximal insertion, Type 2 recession (RT2) in which there is gingival recession but with loss of interproximal insertion, in which the measure of the cemento-enamel junction is less than or equal to the loss of buccal insertion, Recession type 3 (RT3) in which there is gingival recession but with loss of interproximal insertion, in which the measure of the cemento-enamel junction is greater than the loss of oral insertion (Cortellini & Bissada 2020)
The free gingival graft is one of the oldest techniques of gingival grafting, and its efficiency is proven in the long term, but the success of this graft depends on the transplanted connective tissue, its integration takes around 17 days showing a fibrous tissue that can differentiated from the receiving area (Cairo, 2017; Lafzi et al, 2019), which is the main disadvantage of free gingival graft technique (FGG) in aesthetic areas

Summary

Introduction

Gingival recession is defined as the exposure of the root of the dental element in the oral environment, due to the migration of the gingiva in the apical direction. [1]When this occurs, some pathologies can settle in the patient, ranging from the risk of caries, erosion, root hypersensitivity and lack of esthetics (Zucchelli & Sanctis 2000; Zucchelli et al, 2011; Storrer et al, 2019; Fernandes et al, 2021). [1]When this occurs, some pathologies can settle in the patient, ranging from the risk of caries, erosion, root hypersensitivity and lack of esthetics (Zucchelli & Sanctis 2000; Zucchelli et al, 2011; Storrer et al, 2019; Fernandes et al, 2021). The free gingival graft technique (FGG) has great predictability of success in treating gingival recessions, having been widely used to gain keratinized tissue. It has some disadvantages, such as the discrepancy in texture and colormismatch between the healed graft and the graft recipient area (Zucchelli et al, 2006; Zucchelli & Mounssif 2015; Yoshino et al, 2020; Araujo et al, 2021). The use of subepithelial connective tissue graft (CTG) is reported to be the gold standard for correcting these defects, including as its greatest advantage the increase in the volume of soft tissue and the contouring of the gingival margin (Sculean et al, 2014; Thoma et al, 2020)

Methodology

Case Report

Discussion

Conclusion