Management Of Gingival Recession Research Articles

Comparative Evaluation of Coronally Advanced Flap with Modified Coronally Advanced Flap in the Management of Gingival Recession: A Randomized Clinical Trial

Gingival recession is one of the most common esthetic concerns associated with periodontal tissues. As the conventional technique of coronally advanced flap ends up with different disadvantages, a modified technique has been introduced to overcome the limitations. Thus, the two techniques has been planned to compare and evaluate. The study was conducted on 11 randomly selected subjects. In phase I, scaling was done and in phase II, coronally advanced flap technique in control group and modified coronally advanced flap technique in test group was done. Clinical attachment level, probing pocket depth, keratinized tissue width, length and width of recession, pain and healing index was assessed. Results showed a statistically significant reduction in pain index scores, clinical attachment level scores, probing depth scores, recession length and width scores in both the groups were observed. Also, statistically significant increase in healing index scores and keratinized tissue width scores were observed on intragroup comparison. However, on intergroup comparison, test group revealed better results as compared to control group in all the parameters. Thus, from the observation, it was concluded that both the groups has better clinical outcomes but test group showed better results in all the clinical parameters as compared to control group.

Assessment Of The Knowledge And Awareness Towards The Aetiology And Diagnosis For Gingival Recession And Attitude Towards Its Management

Aim– The Aim of the study is to assess of the Knowledge and Awareness towards the aetiology and Diagnosis for Gingival Recession and attitude towards its management among interns and post-graduates. Materials and Methods: 250 dental professionals including interns and postgraduates from diverse specialties participated in an online survey. This self-prepared questionnaire-based survey consisting of 14 questions was carried out at Rama dental college Kanpur for a period of 2 months. Statistical analysis used: Descriptive statistics have been used to summarize and describe the distributions of responses for each question. These statistics include measures like counts, percentages, means, and standard deviation. The Chi-square test and ANOVA test were used to analyze and compare the variables. Results:54.8% of interns and postgraduates had good knowledge and attitude towards aetiology and management of gingival recession, 44.4% had intermediate knowledge whereas 0.8% had poor knowledge. Conclusion: The study concluded that the Knowledge and Awareness towards the aetiology and Diagnosis for Gingival Recession and attitude towards its management among interns and postgraduates was good.

Marine Collagen Matrix Carrier with Injectable Platelet-Rich Fibrin in Management of Gingival Recession Defects

Background. The gold standard in the management of gingival recession (GR) defects has been connective tissue graft (CTG) with coronally advanced flap (CAF). But patient morbidity associated with graft harvesting is a major drawback and has led to the development of various substitute biomaterials which have been tried and tested. Aim. Our study is aimed at checking the efficacy of marine collagen matrix (MCM) impregnated with injectable platelet-rich fibrin (I-PRF) with modified CAF in the treatment of Miller’s class I and II recession defects. Case Description. Six patients with ten GR defects in maxilla were treated with CAF + MCM + I-PRF. Clinical parameters like recession height (RH), recession width (RW), root coverage (RC%), width of attached gingiva (WAG), keratinized tissue height (KTH), probing pocket depth (PPD), clinical attachment level (CAL), gingival biotype (GB), plaque index (PI), and visual analogue score (VAS-E) esthetic scores were evaluated up to six months. There was significant root coverage observed at three- and six-month follow-ups. Conclusion. The proposed treatment was effective in the management of GR defects and improvement in soft tissue biotype without the morbidity associated with soft tissue harvest.

Knowledge and Attitude towards Management of Gingival Recession among Dental Professionals in Puducherry

Knowledge and Attitude towards Management of Gingival Recession among Dental Professionals in Puducherry

Predictability of free gingival graft in management of gingival recession: A case series

This case series study predictability of free gingival graft in management of gingival recession. 3 cases with mucogingival problems needing free gingival grafts were selected. First, the recipient site was anesthetized and de-epithelialization was done and recipient bed was prepared. After tracing the palatal donor site with the aluminium foil template, bleeding points marked and graft was harvested. For root modification of the recipient tooth, conditioning of the dentin was done by the EDTA. Graft is closely adapted over the recipient with Oschenbein and circumferential sutures so there was no dead space left between the root surface and graft, by 5-0 monofilament suture. In case I and III where Miller’s Class II and I gingival recession respectively, there is complete root coverage achieved and in case II Miller’s Class III type of gingival recession present 80% root coverage possible. FGG best alternative for the treatment of gingival recession presents with inadequate width of attached gingiva and depth of vestibular fornix but main disadvantage of FGG is unesthetic appearance, two donor site, donor site morbidity, age and limitation of patient systemic condition. So proper case selection along with definitive treatment planning for every case is necessary.

Evaluation of The Effect of Platelet Rich Fibrin (PRF) Combined With Collagen Membrane in Management of Gingival Recession

Evaluation of The Effect of Platelet Rich Fibrin (PRF) Combined With Collagen Membrane in Management of Gingival Recession

Assessment of various treatment modalities with recent advancements in management of gingival recession: A scoping review

Assessment of various treatment modalities with recent advancements in management of gingival recession: A scoping review

Assessment of various treatment modalities with recent advancements in management of gingival recession: A scoping review

This article gives information regarding various etiological factors that can lead to recession, the pathogenesis behind the recession, under which type it can be classified, the diagnostic criteria for recession, how to assess the root coverage, rationale for the necessary treatment with suitable non-surgical and surgical treatment options, concluding with post-operative care which has to be given to the patients after surgical procedures.

Perceptions of NZ orthodontists and periodontists on the management of gingival recession in orthodontic patients.

This study aimed to investigate the perceptions and opinions of orthodontists and periodontists on the management of gingival recession in orthodontic patients. An online survey was sent to 29 periodontists and 80 orthodontists registered and currently practising in New Zealand. All participants answered questions about the timing and clinical indications of mucogingival surgeries in orthodontic patients diagnosed with mucogingival deformities. Most periodontists and orthodontists believed that gingival grafts should ideally be performed after orthodontic treatment. In clinical practice, 40% of periodontists indicated that they would receive referrals after completion of orthodontic treatment. However, 29.6% of orthodontists indicated that they would refer to a periodontist before orthodontic treatment in clinical practice. The most crucial factor that affected periodontists' decision-making was 'evidence-based guidelines' (35.0%), followed by 'clinical experience' (30.0%) and 'patient concerns' (15.0%). All four factors of 'gingival phenotype', 'presence of gingival recession', 'amount of keratinised tissue' and 'planning specific tooth movements' were equally considered by orthodontists regarding their decision-making. The majority of the surveyed New Zealand periodontists and orthodontists expressed a belief that the ideal timing for the management of gingival recessions would be after the completion of orthodontic treatment.

Management of Gingival Recession by Coronally Advanced Flap with and Without Amniotic Membrane: A Clinical Study.

Purpose:Recently, human amniotic membrane (AM) has been reported to have regenerative potential that facilitate repair in the field of oral and periodontal surgeries.Methods:Eighteen subjects with bilateral Miller's class I gingival recession defects were selected. Subjects were allocated randomly to treatment with coronally positioned flap + amnion allograft (test group) and coronally positioned flap alone (control group). The clinical parameters used in this study were width of attached gingiva (AG), clinical attachment level (CAL), pocket depth (PD), width of keratinized gingiva (WKG), length of gingival recession (RL), width of gingival recession (RW).Results:The mean width of attached gingiva at the control sites (A) was found to be 1.33 ± 0.50 mm (range 1.00–2.00), 2.00 ± 0.71 mm (range 2.00–3.00) and 2.22 ± 0.67 mm (range 2.00–3.00) on day 0, 90 and 180, respectively. Thus, it was increased by 0.67 mm and 0.89 mm on day 90 and 180 compared to that of the baseline, which are 50% and 67%, respectively.Conclusions:It can be concluded that combined coronally advanced flap and amniotic membrane have additional advantage in the outcome of periodontal therapy in the management of gingival recession.

Evaluation of Effectiveness of Platelet Rich Fibrin Matrix (PRFM) Membrane and Platelet Rich Fibrin (PRF) Membrane using Vestibular Incision Subperiosteal Tunnel Access (VISTA) Approach Technique for the Treatment of Multiple Gingival Recession Defects in Humans – A Study Protocol

Background: To evaluate the effectiveness of Platelet Rich Fibrin Matrix (PRFM) membrane and Platelet Rich Fibrin (PRF) membrane using Vestibular Incision Subperiosteal Tunnel Access (VISTA) Approach method for the management of multiple gingival recession (GR) defects in humans.
 Methodology: 20 subjects with gingival recession will be enrolled. 10 patient will be randomly allotted to test group (PRFM membrane) or control group (PRF membrame). Primary outcome will be gain in root coverage (RC) and secondary outcome will be Plaque index (PI), Papillary bleeding index (PBI), probing pocket depth (PPD), relative attachment level (RAL), relative gingival margin level (RGML), recession depth (RD), gingival thickness (GT) and width of keratinized gingiva (WKG). Clinical evaluation will be performed at 3 & 6 months of therapy.
 Expected Results: When all the parameters will be compared at 6 months post-operatively to baseline data, both the treatment group (test and control) will be expected to show significant gain in RC, RAL gain, PPD reduction, decrease in RD, increase in GT and WKG. PRFM membrane will result in significant gain in RC, RAL gain, PPD reduction, and decrease in reduction depth, increase in GT and WKG at 6 months when compared to PRF membrane.
 Conclusion: PRFM membrane will be effectual in management of gingival recession. PRFM membrane is expected to have significantly greater outcome as compared to PRF membrane group.

Gingival mask for conservative management of gingival recession: A case report

Smile is the jewel of the face, which not only enhances the beauty of the person but also influences self-confidence. Dental esthetic is composed of white and pink component. The long-term periodontal disease results in the destruction of the pink component leading to gingival recession in some cases, which results in elongated tooth with black triangle and unesthetic smile. When severe destruction is present in the maxillary anterior region surgical reconstruction is unpredictable. This destruction can be masked with a prosthesis like gingival mask after the control of periodontal disease. This case report describes the use of the gingival mask as a conservative treatment modality for recession, achieving optimum esthetics and patient satisfaction.

Evaluating the efficacy of human placental amnion membrane in combination with modified coronally advanced flap technique in the management of gingival recession: An interventional study

Aims and objectives: A common problem experienced by adults is the recession of the gingiva resulting in unpleasant appearance of their teeth. There are various techniques to achieve the gingival recession coverage (GRC). But, only few techniques such as connective tissue grafts, coronally advanced flap technique (CAF) have been proved effective in achieving 100% recession coverage. The present study aims at evaluating the efficacy of amnion membrane along with CAF in the management of GRC. Materials and methods: A total number of 10 patients with class I or class II gingival recession were included in the study. The clinical parameters such as Probing depth (PD), clinical attachment level (CAL), thickness of attached gingiva (TAG), width of keratinized gingiva (WKG), height of gingival recession (HGR), percentage of recession coverage (PRC) and recession coverage esthetic score (RCES) were measured at baseline, 3 months and 6 months post-operatively. The patients were treated using amnion membrane in combination with modified coronally advanced flap technique (MCAF). Results: The patients showed statistically significant improvement in all the clinical parameters at the 3 months and 6 months follow-up visit. 97.8% CRC was observed by the end of 6 months. Moreover, the RCES showed remarkable esthetic outcome at the post-operative 6 months visit. Conclusion: Modified coronally advanced flap technique produces excellent clinical outcomes in terms of GRC. The use of amnion membrane aids in faster healing and improves the TAG which is an important aspect for the long term stability of the results obtained. Keywords Amnion membrane, Coronally advanced flap, Gingival recession, Guided tissue regeneration, Recession coverage

Efficacy of Coronally Advanced Flap with and Without Augmentation in The Management of Gingival Recession: A Systematic Review

Efficacy of Coronally Advanced Flap with and Without Augmentation in The Management of Gingival Recession: A Systematic Review

Leukocyte - Platelet Rich Fibrin (L-PRF) in Combination with Tunneling Technique in Management of Gingival Recession: Randomized Clinical Study

Leukocyte - Platelet Rich Fibrin (L-PRF) in Combination with Tunneling Technique in Management of Gingival Recession: Randomized Clinical Study

Laterally Displaced Pedicle Flap for the Management of Localised Gingival Recession: A Case Report

Gingival recession, whenever presents with sensitivity, aesthetic problem, root caries or difficulty in plaque control may pose a challenge for clinicians. Among the various treatment modalities for root coverage, laterally displaced flap has been a promising treatment for isolated gingival recession with an adequate amount of donor tissue adjacent to the recipient site. This case report presents a case of successful root coverage where laterally displaced flap was employed for the management of gingival recession in mandibular central incisor with two and a half years follow up.

Clinical efficacy of xenogeneic and allogeneic 3D matrix in the management of gingival recession: a systematic review and meta-analysis.

A systematic review and meta-analysis was thus conducted to answer the following focused question based on PICO strategy: Is there any 3D matrix biomaterial used for root coverage of human Miller class I and II defects equivalent with the connective tissue graft in localized defects of at least 2mm and 3mm? The search on electronic database included MEDLINE, Cochrane Central Register of Controlled Trials, Clinical Trials.gov, Web of Science, and New Zealand/Australian Clinical Trials. Only randomized clinical trials (RCTs) that compared connective tissue graft (CTG) with at least one 3D matrix alone for root coverage in Class I and II Miller localized defects of at least 2mm, with at least 6months follow-up, were included in this systematic review. A total of 14 studies were included for meta-analysis (12 compared CTG with acellular dermal matrix allograft and 2 compared CTG with Xenogenic Collagen Matrix). Relative root coverage showed no significant difference among the materials, for either 2 or 3mm minimal recessions. For keratinized tissue width, on 2mm recessions, CTG showed superiority above other biomaterials, but on 3mm recessions, it seemed to have the same results. The percentage of recessions with complete root coverage for both 2 and 3mm recessions showed similar results for all biomaterials. With their limits, the present data concluded that CTG, acellular dermal matrix allograft, and xenogenic collagen matrix provided similar results for root coverage. To know if there is a 3D matrix with equivalent predictable results for root coverage, that we could avoid the morbidity of the connective tissue graft for these cases.

A novel soft tissue cone-beam computed tomography study in the evaluation of gingival thickness associated with subepithelial connective tissue graft versus acellular dermal matrix in the management of gingival recession: A clinical study.

Background:Dental esthetic awareness among patients led the clinicians to introduce newer materials and predictable techniques that satisfy the patients' esthetic demands.Aim:To evaluate and compare the efficacy of subepithelial connective tissue graft (SECTG) and acellular dermal matrix (ACDM) allograft in the treatment of Millers Class I or Class II recession with the determination of gingival thickness using an impertinent method, soft tissue cone-beam computed tomography (ST-CBCT).Materials and Methods:A split-mouth study with a total of ten patients with bilateral Millers class I or class II recession is randomly assigned by a coin toss method as Group I (SECTG) and Group II (ACDM) along with coronally advanced flap. Clinical parameters including recession height (RH), recession width (RW), probing depth, clinical attachment level (CAL), and height of keratinized tissue (HKT) were evaluated at baseline, 90th day, and 180th day for both groups. The thickness of keratinized tissue (TKT) was determined by most reliable, predictable and noninvasive method called ST-CBCT.Results:Statistically significant reduction in RH and RW, gain in CAL, and increase in HKT and TKT in both Group I and Group II were seen in 90th day and 180th day. However, when both Group I and Group II were compared between 0 and 180th day, the change in RH and RW, gain in CAL, and increase in HKT and TKT did not show any statistically significant change.Conclusion:The present study suggested that root coverage with both SECTG and ACDM is very predictable procedure and it is stable for 6 months. ST-CBCT is a newer dimension in periodontal imaging and will certainly aid clinicians in the execution of various treatment modalities with increased predictability.

Management of inadequate keratinized gingiva and millers class III or IV gingival recession using two-stage free gingival graft procedure.

Background:Prognosis in the management of Millers Class III or IV gingival recession is often fair to poor, which is further decreased by factors such as inadequate keratinized gingiva. Very few modalities show long-term success in the management of gingival recession with inadequate keratinized gingiva, free gingival graft (FGG) being one such technique.Materials and Methods:Ten individuals with Millers Class III or IV recession and inadequate keratinized gingiva were recruited for the study. The first surgical procedure involved the FGG procedure to increase the width of keratinized gingiva (WOKG). Patients were recalled after 3 months for the second surgical procedure, where the flap was coronally advanced. They were recalled 9 months after the second surgery. WOKG was examined at baseline and 3 months (before the second surgical procedure). Recession depth (RD) and clinical attachment level (CAL) was examined at baseline, at 3 months (before the second surgical procedure) and at 12 months (9 months after the second surgical procedure). The percentage of root coverage was measured at 12 months from baseline.Results:Significant increase in WOKG was seen at 3 months. Significant decrease in RD and CAL was observed at 12 months from baseline. The percentage of root coverage was 76.4%.Conclusion:Two-stage FGG procedure can be a successful modality in the management of Millers Class III or IV recession with inadequate keratinized gingiva. This technique improves the prognosis of such compromised cases.

Management of gingival recessions: options and prognostic factors

Surgical coverage of exposed root surfaces is one of the most common treatments in plastic periodontal surgery. The review describes established recession coverage including the application of coronal and lateral advanced flaps, soft tissue grafts as well as their combinations and tunneling procedures. Patient-related, defect-orientated and technique-based factors will be addressed that mainly influence the success of root coverage and, therefore, should be considered in pre-surgical treatment planning. An indication scheme presents differential indications of the most important techniques depending on clinical parameters.