Abstract

This case series reports the various treatment modalities to treat the multiple recessions. Gingival recession is a widespread clinical manifestation affecting single or multiple root surfaces at all teeth types. Periodontal reconstructive surgery consists of various mucogingival procedures. The primary goal of these procedures is to benefit periodontal health through the reconstruction of lost hard and soft tissues, or by preventing its additional loss, and also enhancing the esthetic appearance. Platelet-rich fibrin is a second generation platelet concentrate and is defined as an autologous leukocyte and platelet-rich fibrin biomaterial. Care was taken not to extend the incisions till the tip of the interdental papilla. A full thickness mucoperiosteal flap was reflected, extending beyond the mucogingival junction. A wide range of surgical techniques has been proposed for the treatment of the gingival recessions, each with its advantages and disadvantages. To provide predictable and long-term results, it is of paramount importance that the surgical technique is individually selected, taking into account several crucial factors such as the size of the defect, the width of the keratinised gingiva apical to the defect and the thickness of the flap.

Highlights

  • Gingival recession is a widespread clinical manifestation affecting single or multiple root surfaces at all teeth types [1]

  • A patient reported to the department of periodontics with class II multiple recession wrt to 13-17 .Coronally advanced flap raised along with platelet richfibrin membrane was placed on surgical site, suturing done and periodontal pack was given and with 2 years follow up 85% of root coverage was achieved

  • Scientific literature is sparse regarding the treatment of multiple adjacent recession type defects (MARTD) and randomized control trials (RCTs) are needed to identify the indication for each surgical technique and any prognostic factors (Chambrone et al 2009)

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Summary

INTRODUCTION

Gingival recession is a widespread clinical manifestation affecting single or multiple root surfaces at all teeth types [1]. The periodontal reconstructive procedures was done to achieve complete and predictable coronal displacement of the gingival margin on all root surfaces. The primary goal of these procedures is to benefit periodontal health through the reconstruction of lost hard and soft tissues, or by preventing its additional loss, and enhancing the esthetic appearance. The various plastic procedures performed to enhance esthetics or relieve hypersensitivity due to exposed root surfaces are, the Laterally Positioned Flap Technique, Free Gingival Graft Technique, Connective Tissue Graft Techniques, Free Gingival Graft/Coronally Positioned Flap Technique, Guided Tissue Regeneration Technique, and the Acellular Dermal Matrix Technique. A recent systematic review reported the best predictability in complete root coverage when adjacent Miller class I and II recession defects were treated by the coronally advanced flap with or without the connective tissue graft [5,6]. Various other additive materials are available like the acellular dermal matrix, PRF as a membrane or aminiotic membranes

Case 1
Case 2
Pouch and tunnel technique
Case 4
Case 5
Free gingival graft
Findings
DISCUSSION
CONCLUSION
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