Recession Coverage Research Articles

PC142: Root coverage of gingival recessions with connective tissue graft. Comparative study of three different root surface treatment

PC142: Root coverage of gingival recessions with connective tissue graft. Comparative study of three different root surface treatment

PD169: A combined restorative and periodontal plastic surgical approach for root coverage of multiple gingival recessions associated with non‐carious cervical lesions – Clinical report presentation

PD169: A combined restorative and periodontal plastic surgical approach for root coverage of multiple gingival recessions associated with non‐carious cervical lesions – Clinical report presentation

PC086: Double papilla flap and connective tissue graft in the coverage of gingival recessions using microsurgery: case series

PC086: Double papilla flap and connective tissue graft in the coverage of gingival recessions using microsurgery: case series

PC141: Root coverage of anterior lingual multiple recessions with subepithelial connective tissue graft: a case report

PC141: Root coverage of anterior lingual multiple recessions with subepithelial connective tissue graft: a case report

PC073: Coronally advanced flap combined with connective tissue graft technique for the treatment of deep gingival recession and root coverage: a case report

PC073: Coronally advanced flap combined with connective tissue graft technique for the treatment of deep gingival recession and root coverage: a case report

PR326: Mucogingival recession coverage by “coronally advanced flap in combination with enamel matrix derivative” (Emdogain) and “coronally advanced flap in combination with subepithelial tissue graft”

PR326: Mucogingival recession coverage by “coronally advanced flap in combination with enamel matrix derivative” (Emdogain) and “coronally advanced flap in combination with subepithelial tissue graft”

PD172: The clinical effect of Hyaluronic acid on root recession coverage: a case series, 6 months evaluation

PD172: The clinical effect of Hyaluronic acid on root recession coverage: a case series, 6 months evaluation

Sub-epithelial connective tissue graft for the management of Miller's class I and class II isolated gingival recession defect: A systematic review of the factors influencing the outcome.

The aim of the present systematic review was to analyze the factors that affect the outcome of subepithelial connective tissue graft (SCTG) for managing Miller's class I and class II isolated gingival recession defect. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for systematic reviews were used. Quality assessments of selected articles were performed. Data on root surface condition, recession type defect, flap thickness, different flap designs, different harvesting techniques, presence/absence of the epithelial collar, graft thickness, flap tension, suturing techniques, and smoking-related outcomes on root coverage were assessed. The SCTG procedure provides the best root coverage outcomes for Miller's class I and class II recession. The critical threshold of flap thickness was found to be 1mm. Maximum root coverage was achieved by envelope and modified tunnel technique. SCTG with the epithelial collar does not provide additional gains than SCTG without the epithelial collar. The thickness of SCTG for root coverage was found to be 1.5-2mm. Greater flap tension and smoking adversely affect root coverage outcomes. Analysis of the factors discussed would be of key importance for technique selection, and a combined approach involving factors favoring outcomes of SCTG could be of clinical relevance in recession coverage.

Recession coverage using coronally advanced flap with Pericardium® membrane (collagen Type I) - A case report

Recession coverage using coronally advanced flap with Pericardium® membrane (collagen Type I) - A case report

A Comparative Split Mouth Clinical Evaluation of Amniotic Membrane and Platelet Rich Fibrin in Patients with Gingival Recession: Two Case Reports

Gingival recession designates the oral exposure of root surface due to the displacement of gingival margin apical to cementoenamel junction. This is split mouth design study of two patients, the first of its kind, wherein patients having bilateral isolated recession were undertaken. Both the patients were treated using Coronally Advanced Flap (CAF) with Amniotic Membrane (AM) on left side and CAF with Platelet Rich Fibrin (PRF) on right side. Recession height, width of keratinized gingiva, Probing Pocket Depth (PPD) was recorded. Patient was recalled after 3 and 6 months. The clinical outcome of these surgical procedure accounted for complete recession coverage and increase in width of keratinized gingiva, with both CAF with AM and CAF with PRF. Furthermore, the results were stable even after six months.

Clinical evaluation of acellular dermal matrix allograft (Alloderm) with coronally advanced flap in the treatment of multiple gingival recessions: A clinical study

Aims: The purpose of this study was to clinically evaluate the efficacy of Alloderm® with the coronally positioned flap in the treatment of multiple gingival recessions and to assess the esthetic and hypersensitivity evaluation from patient's perspective using visual analog scale (VAS). Subjects and Methods: A total of 10 systemically healthy male and female patients aged 18–50 years with Miller's class I and class II gingival recessions, who had dentin hypersensitivity and esthetic concern were selected for the study. Root coverage (RC) was done using coronally advanced flap with Alloderm®. Statistical Analysis: Descriptive statistical analysis was performed in the present study. Significance was assessed at 5% level of significance. Student's t-test was conducted to find the pairwise significance of the study parameters. Wilcoxon signed-rank test was used to find the significance of percentage of linear RC and percentage of volumetric RC (% of VRC) between 3 and 6 months. Results: A total 31 defects were treated with mean volumetric percentage RC (%RC) at 3 months of 35.21%. This remained the same at 6 months (P = 1.000). There was no statistically significant difference in the volumetric and Linear percentage of root coverage. Dentine hypersensitivity and esthetics were evaluated from patient's perspective using VAS ranging from a score of 0–10. Where 0 indicates very low and score of 10 indicates very high score. VAS indicated a decrease in the sensitivity after treatment. VAS mean score before treatment was 6.22 ± 0.83 with a mean score of 3.90, standard deviation (SD) of ± 1.37 after treatment and mean score of 5.10, SD of ± 0.57 for esthetic evaluation. Conclusions: The use of Alloderm® with coronally positioned flap provided a significant improvement in all the clinical parameters, but did not result in favorable outcome in terms of root coverage of facial gingival recessions of multiple adjacent teeth.

Epithelial Inclusions Following a Bilaminar Root Coverage Procedure with a Subepithelial Connective Tissue Graft: A Histologic and Clinical Study.

The aim of this study was to histologically examine any epithelial cell inclusions in submerged subepithelial connective tissue graft (SCTG) after clinical healing was achieved. A total of 16 patients with Miller Class I or II gingival recessions were consecutively treated with a bilaminar procedure. At 2 months after surgery, a gingival tissue specimen was harvested from all SCTG-treated sites and stained with hematoxylin-eosin. The histologic evaluation revealed connective tissue in active reorganization without epithelial inclusions in 14 of the 16 tissue specimens. In the remaining 2 specimens, epithelial islands were observed deep in the connective tissue. In one case they developed in a solid cystic space, while in the second case they were strictly integrated in the lamina propria. Complete recession coverage was obtained in 14 of the 16 treated defects, with a mean root coverage of 95.1% ± 14.2% at 12 months.

Enhancing Root Eminence and Papilla Contour Using Single, Contoured, Subepithelial Connective Tissue Autografts for Recession Coverage.

Current techniques using autogenous soft tissue in periodontal plastic surgery have limitations in the number of teeth that can be treated and may result in suboptimal esthetic results. The innovative use of single, contoured grafts reported in this article overcomes the drawbacks associated with these techniques by more efficient use of available donor tissue. Autogenous tissue is used to graft each individual tooth, leaving the interdental areas uncovered. Multiple teeth-in some cases an entire arch-can be treated in one session, providing consistent and predictable reestablishment of the normal scalloped gingival architecture and convex root eminence.

Recession coverage with minimally invasive surgical therapy

Recession coverage with minimally invasive surgical therapy

Multiple Gingival Recession Coverage Treated with Vestibular Incision Subperiosteal Tunnel Access Approach with or without Platelet-Rich Fibrin - A Case Series.

Background:Gingival recession involves both soft tissue and hard tissue loss. In this evolutionary era of dentistry, newer techniques have evolved for complete coverage of isolated recession defects. Since 2012, vestibular incision subperiosteal tunnel access (VISTA) technique was used with various regenerative membranes to treat multiple recession defects (MRDs). Platelet-rich fibrin (PRF) membrane, a pool of growth factors but have any added advantage to recession coverage techniques is controversial. Thus, in this case series, we compare the effect of VISTA with or without PRF-membrane for the treatment of Classes I and III MRDs.Subjects and Methods:Four patients between of age 30 and 40 years (two patients having bilateral Class I and another two having bilateral Class III MRDs) were selected from the Department of Periodontics, ITS Dental College, Greater Noida and designated as Case I–IV simultaneously. Recession defects at antagonist sites in each patient were corrected by VISTA approach with or without PRF-membrane. Recorded clinical parameters included recession depth, recession width, pocket probing depth, and clinical attachment level (CAL) at baseline and 6 months postoperatively.Results:Patients having Class I recession defects showed almost complete root coverage with VISTA technique alone and reflected no added advantage of PRF-membrane. However, patients with Class III recession defects treated with VISTA + PRF-membrane showed more reduction in recession depth and gain in CAL as compared to sites treated with VISTA only.Conclusion:VISTA alone is a convenient technique for treatment of Class I MRDs. Addition of PRF-membrane for Class III recession defects give better outcome in term of reduction of recession depth and gain in CAL 6 month postoperatively.

Clinical evaluation of acellular dermal matrix allograft (Alloderm®) with coronally advanced flap in the treatment of multiple gingival recessions: A clinical study

Aims: The purpose of this study was to clinically evaluate the efficacy of Alloderm® with the coronally positioned flap in the treatment of multiple gingival recessions and to assess the esthetic and hypersensitivity evaluation from patient's perspective using visual analog scale (VAS). Subjects and Methods: A total of 10 systemically healthy male and female patients aged 18–50 years with Miller's class I and class II gingival recessions, who had dentin hypersensitivity and esthetic concern were selected for the study. Root coverage (RC) was done using coronally advanced flap with Alloderm®. Statistical Analysis: Descriptive statistical analysis was performed in the present study. Significance was assessed at 5% level of significance. Student's t-test was conducted to find the pairwise significance of the study parameters. Wilcoxon signed-rank test was used to find the significance of percentage of linear RC and percentage of volumetric RC (% of VRC) between 3 and 6 months. Results: A total 31 defects were treated with mean volumetric percentage RC (%RC) at 3 months of 35.21%. This remained the same at 6 months (P = 1.000). There was no statistically significant difference in the volumetric and Linear percentage of root coverage. Dentine hypersensitivity and esthetics were evaluated from patient's perspective using VAS ranging from a score of 0–10. Where 0 indicates very low and score of 10 indicates very high score. VAS indicated a decrease in the sensitivity after treatment. VAS mean score before treatment was 6.22 ± 0.83 with a mean score of 3.90, standard deviation (SD) of ± 1.37 after treatment and mean score of 5.10, SD of ± 0.57 for esthetic evaluation. Conclusions: The use of Alloderm® with coronally positioned flap provided a significant improvement in all the clinical parameters, but did not result in favorable outcome in terms of root coverage of facial gingival recessions of multiple adjacent teeth.

Comparative Evaluation of Platelet Rich Fibrin and Dehydrated Amniotic Membrane for the Treatment of Gingival Recession- A Clinical Study.

The main objective of any therapeutic intervention aimed at root coverage is to restore the tissue margin to the cemento-enamel junction and to regenerate the lost periodontium. To compare the effectiveness of Platelet Rich Fibrin (PRF) and Amniotic Membrane (AM) in the treatment of gingival recession by Coronally Advanced Flap (CAF) Technique. Thirty systemically healthy patients who met inclusion-exclusion criteria were selected. After Phase-I therapy, patients were randomly allocated to one of the groups; PRF (Group-A) and Amnion Group (Group-B). Clinical parameters like Plaque Index (PI), Recession Depth (RD) and Width of Keratinized Gingiva (WKG) were measured on the baseline day, three months and six months postoperatively. Mann-Whitney test and Wilcoxon signed ranks test were applied for intergroup and intragroup comparisons respectively. Intergroup comparison between platelet rich fibrin and amniotic membrane showed statistically insignificant difference in the recession depth and width of keratinized gingiva at three and six months postoperatively. Both the membranes were equally effective in terms of recession coverage and increase in width of keratinized gingiva.

Inclusion of guided tissue regeneration membrane for the management of multiple gingival recession

Gingival recession (GR) is not only a major esthetic concern but also is often associated with dentinal hypersensitivity. Correction of mucogingival recession deformities with a variety of periodontal plastic surgical procedures has been described, each demonstrating a variable degree of success. However, among the various treatment modalities, coronally advanced flaps are the most commonly employed for multiple teeth recession coverage. This case report describes the management of Class I GR due to faulty brushing technique associated with dentinal hypersensitivity with coronally advanced flap combined with guided tissue regeneration membrane.

Gingival recession coverage using submerged graft with root surface biomodification

Aesthetic demand has increased tremendously in the recent years and so has the demand for the consequent cosmetic periodontal surgeries. One of the most common aesthetic problems encountered is the gingival recession, especially in the anterior region. Gingival recession is the exposure of root surface due to apical migration of gingival margin. Many patients seek treatment because of aesthetic concerns, root sensitivity or fear of loss of affected tooth. This case report describes management of gingival recession using connective tissue graft and laterally repositioned flap after root surface biomodification.

Coverage of mucosal recessions at dental implants.

Facial peri-implant mucosal recessions represent an increasing complication in implant dentistry and may negatively affect the esthetic outcome and patient satisfaction. The aim of the present paper is to provide a review on the potential causes of facial peri-implant mucosal recessions and to provide a rationale for treatment along with possible treatment options. The available data indicate that soft tissue augmentation around dental implants is possible, but at present there is no evidence demonstrating that the augmented soft tissues are able to influence the peri-implant bone levels (e.g. to limit peri-implant bone loss). Therefore, the rationale to cover or correct peri-implant mucosal recessions are (i) to optimize the possibility for performing an adequate level of oral hygiene, and (ii) to improve esthetics. At present, there is very limited evidence supporting any specific treatment modality for covering peri-implant soft tissue recessions. The limited available data indicate that only shallow peri-implant mucosal recessions (e.g. up to 2mm) may be treated successfully by means of a coronally advanced flap and subepithelial connective tissue graft or with guided bone regeneration, while no data are available supporting the possibility of covering deep and large peri-implant mucosal recessions.