Clinical Outcomes of the Double Lateral Sliding Bridge Flap Technique with Simultaneous Connective Tissue Graft in Sextant V Recessions: Three-Year Follow-Up Study

Norberto Quispe-López,Pablo Garrido-Martínez,Cristina Gómez-Polo,Jesús Mena-Álvarez,Beatriz Pardal-Peláez,Javier Montero-Martín,Antonio Castaño-Séiquer

doi:10.3390/app12031038

Norberto Quispe-López, Pablo Garrido-Martínez + Show 5 more

Open Access

https://doi.org/10.3390/app12031038

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Abstract

The presence of isolated or multiple gingival recessions in the mandibular anterior region is a challenge for the clinician, as they may be associated with a shallow vestibule, high frenum insertion and/or little or no attached gingiva. Only limited evidence is available on the use of the double lateral sliding bridge flap technique with connective tissue graft (CTG) technique for treating gingival recessions in the mandibular anterior region. The aim of this study was to describe and evaluate the clinical and esthetic outcomes of the double lateral sliding bridge flap technique with CTG on isolated and multiple gingival recessions at the level of the mandibular incisors. Nine patients required treatment of gingival recessions in the mandibular incisors at the University of Salamanca (Spain) (seven females, two males; mean age: 27.9 ± 6.9) with a total of 14 isolated (42.9%) and multiple (57.1%) Miller class II and III gingival recessions. After a mean follow-up of 36 months, the mean percentage of root coverage was 80.5% for all treated recessions. Statistically significant differences (p < 0.05), were observed for reduction in recession depth, increased width of keratinized tissue and increased gingival thickness, this being dependent on the Miller class. The esthetic outcome was acceptable, with a final mean esthetic score of 7.4 out of 10. The double lateral sliding bridge flap surgical technique with CTG is an effective procedure for the coverage of isolated and multiple gingival recessions in the anterior mandibular region, as it offers satisfactory esthetic results.

Highlights

Gingival recession (GR) is defined as the apical displacement of the gingival margin in relation to the cementoenamel junction (CEJ), which exposes the root surfaces to the oral environment and is associated with attachment loss [1]
Most clinical trials tend to focus on maxillary gingival recessions, while little information is available on treatment of mandibular defects [12]
The results obtained in the present study prove that a connective tissue graft (CTG) together with the double lateral sliding bridge flap technique is a valid treatment option for the coverage of gingival recessions in the mandibular anterior region

Summary

Introduction

Gingival recession (GR) is defined as the apical displacement of the gingival margin in relation to the cementoenamel junction (CEJ), which exposes the root surfaces to the oral environment and is associated with attachment loss [1] It occurs frequently in adults and increases with age [2], regardless of the level of oral hygiene [3]. It has been shown that complete root coverage in single and multiple recessions can be predictably achieved with different techniques [7,8] Of these procedures, the coronally advanced flap with connective tissue graft (CTG) is the most effective treatment of recession with or without clinical interproximal attachment loss [9,10,11]. It is important to remember that orthodontics has a vital role in managing and resolving periodontal problems [15]

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