Abstract
Achieving the coverage of multiple adjacent gingival recessions (MAGRs) in a single surgical procedure poses a major clinical challenge. The gold standard procedure involves the collection of autogenous connective tissue from the palatal mucosa. In case of reduced palatal tissue thickness, augmentation using a collagen sponge can be performed. The aim of this study was to compare the treatment outcome of MAGR coverage by a coronally advanced flap (CAF) along with a connective tissue graft (CTG) harvested from augmented or nonaugmented palatal mucous membrane. Thirty-five patients with 148 MAGRs were enrolled in the study. The recessions were covered with CTGs collected from 26 augmented- (test group) and from 24 nonaugmented (control group) palatal donor sites followed by a CAF. Clinical parameters were measured at baseline, 6, 12 and 24 months after intervention. Clinical results for both, the test and the control group were steady and similar with the exception of buccal gingival thickness (BGT1). After 24 months, statistically greater BGT1 and complete root coverage (CRC) was observed in the test group. The augmented CTG+CAF method achieves good and predictable clinical results in the coverage of MAGRs. It leads to the increase of gingival thickness in comparison to the nonaugmented intervention.
Highlights
Gingival recessions are single or multiple, partially exposed root surfaces of teeth connected with an apical shift of marginal gingiva in relation to the cemento-enamel junction [1].The etiology of gingival recession is multifactorial
Iatrogenic factors that occur during dental treatment, parafunctions or even chemical damage may result in the development of gingival recession
The main surgical methods used in the treatment of gingival recession are mucogingival procedures with flap preparation, tunnel techniques together with autogenous connective tissue grafts, free gingival grafts and partially de-epithelialized free gingival grafts [28,29,30,31]
Summary
Gingival recessions are single or multiple, partially exposed root surfaces of teeth connected with an apical shift of marginal gingiva in relation to the cemento-enamel junction [1]. The etiology of gingival recession is multifactorial. Possible morphological factors are the anatomy of bone structure as well as the size, shape and position of teeth and the surrounding soft tissues including gingiva, mucous membranes and muscles. Iatrogenic factors that occur during dental treatment, parafunctions or even chemical damage may result in the development of gingival recession. Another important etiological factor is the excessive accumulation of dental plaque, which in result will lead to the inflammation of periodontal tissue and to the loss of clinical attachment. Female sex and age have been stated as possible risk factors [2]
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