Exposed Root Surfaces Research Articles

Root caries: Prevalence, risk indicators, and clinical characteristics – A cross-sectional study

Objectives: The objectives of this study were to determine the prevalence of root caries (RC) in South Coastal population of India, to identify the risk indicators associated with it and to describe some clinical characteristics of RC lesions. Materials and Methods: A cross-sectional study was conducted with a sample size of 1062 subjects to assess the prevalence of RC. Each subject underwent an oral examination, performed by a single-calibrated examiner. Questionnaires were used to collect the data on oral hygiene habits, diet, smoking, alcohol habits, systemic conditions, and education level. Univariate and multivariable regression analyses were performed to identify the risk indicators associated with RC. Results: The prevalence of RC was found to be 7.5%, with a mean RC Index of 17.66%. The results of multiple logistic regression showed that age (≥40 years), systemic conditions, and exposed root surfaces were statistically significantly associated with RC (P < 0.05). Conclusion: RC is prevalent not only in the older age group but also the younger adults in this cohort. This study suggests an association between RC and the variables age (≥40 years), exposed root surfaces and systemic conditions.

Lateral pedicle graft for the treatment of isolated tooth recession

ABSTRACT Gingival recession is defined as the apical migration of the gingival margin from its normal position leading to exposure of the root surface. It not only poses problems in maintaining good oral hygiene but also simultaneously hampers the esthetics. In the present case, the patient came up with a complaint of a denuded root surface due to apical migration of the gingival margin and also a complaint of sensitivity in the same. The case was diagnosed as chronic generalized gingivitis with localized periodontitis in relation to 31. Based on the clinical outcomes, the lateral pedicle graft (LPG) technique was performed. A complete coverage of the exposed root surface was achieved. This case report shows that a simple technique of root coverage like LPG can result in the successful coverage of the denuded root surface.

Novel Resin-Based Antibacterial Root Surface Coating Material to Combat Dental Caries.

Root caries caused by cariogenic bacteria are a burden on a large number of individuals worldwide, especially the elderly. Applying a protective coating to exposed root surfaces has the potential to inhibit the development of caries, thus preserving natural teeth. This study aimed to develop a novel antibacterial coating to combat root caries and evaluate its effectiveness using the antibacterial monomer dimethylaminohexadecyl methacrylate (DMAHDM). DMAHDM was synthesized and incorporated into a resin consisting of 55.8% urethane dimethacrylate (UDMA) and 44.2% TEG-DVBE (UV) at a 10% mass fraction of glass filler. Multiple concentrations of DMAHDM were tested for their impact on the resin's mechanical and physical properties. S. mutans biofilms grown on resin disks were analyzed for antibacterial efficacy. Cytotoxicity was assessed against human gingival fibroblasts (HGFs). The results showed an 8-log reduction in colony-forming units (CFUs) against S. mutans biofilm (mean ± sd; n = 6) (p < 0.05) when 5% DMAHDM was incorporated into the UV resin. There was a 90% reduction in metabolic activity and lactic acid production. A low level of cytotoxicity against HGF was observed without compromising the physical and mechanical properties of the resin. This coating material demonstrated promising physical properties, potent antibacterial effects, and low toxicity, suggesting its potential to protect exposed roots from caries in various dental procedures and among elderly individuals with gingival recession.

A cost-effectiveness analysis of fluoride varnish application in preventing Root caries in elderly persons: a Markov simulation study

BackgroundRoot caries are prevalent issues that affect dental health, particularly among elderly individuals with exposed root surfaces. Fluoride therapy has shown effectiveness in preventing root caries, but limited studies have addressed its cost-effectiveness in elderly persons population. This study aimed to evaluate the cost-effectiveness of a fluoride treatment program for preventing root caries in elderly persons within the context of Chinese public healthcare.MethodsA Markov simulation model was adopted for the cost-effectiveness analysis in a hypothetical scenario from a healthcare system perspective. A 60-year-old subject with 23 teeth was simulated for 20 years. A 5% sodium fluoride varnish treatment was compared with no preventive intervention in terms of effectiveness and cost. Tooth years free of root caries were set as the effect. Transition probabilities were estimated from the data of a community-based cohort and published studies, and costs were based on documents published by the government. The incremental cost-effectiveness ratio (ICER) was calculated to evaluate cost-effectiveness. Univariate and probabilistic sensitivity analyses were performed to evaluate the influence of data uncertainty.ResultsFluoride treatment was more effective (with a difference of 10.20 root caries-free tooth years) but also more costly (with a difference of ¥1636.22). The ICER was ¥160.35 per root caries-free tooth year gained. One-way sensitivity analysis showed that the risk ratio of root caries in the fluoride treatment group influenced the result most. In the probabilistic sensitivity analysis, fluoride treatment was cost-effective in 70.5% of the simulated cases.ConclusionsRegular 5% sodium fluoride varnish application was cost-effective for preventing root caries in the elderly persons in most scenarios with the consideration of data uncertainty, but to a limited extent. Improved public dental health awareness may reduce the incremental cost and make the intervention more cost-effective. Overall, the study shed light on the economic viability and impact of such preventive interventions, providing a scientific basis for dental care policies and healthcare resource allocation.

Biofabrication Strategies for Oral Soft Tissue Regeneration.

Gingival recession, a prevalent condition affecting the gum tissues, is characterized by the exposure of tooth root surfaces due to the displacement of the gingival margin. This review explores conventional treatments, highlighting their limitations and the quest for innovative alternatives. Importantly, it emphasizes the critical considerations in gingival tissue engineering leveraging on cells, biomaterials, and signaling factors. Successful tissue-engineered gingival constructs hinge on strategic choices such as cell sources, scaffold design, mechanical properties, and growth factor delivery. Unveiling advancements in recent biofabrication technologies like 3D bioprinting, electrospinning, and microfluidic organ-on-chip systems, this review elucidates their precise control over cell arrangement, biomaterials, and signaling cues. These technologies empower the recapitulation of microphysiological features, enabling the development of gingival constructs that closely emulate the anatomical, physiological, and functional characteristics of native gingival tissues. The review explores diverse engineering strategies aiming at the biofabrication of realistic tissue-engineered gingival grafts. Further, the parallels between the skin and gingival tissues are highlighted, exploring the potential transfer of biofabrication approaches from skin tissue regeneration to gingival tissue engineering. To conclude, the exploration of innovative biofabrication technologies for gingival tissues and inspiration drawn from skin tissue engineering look forward to a transformative era in regenerative dentistry with improved clinical outcomes.

Treatment of Multiple RT1 Gingival Recessions Using a Coronally Advanced Flap Associated with L-PRF or Subgingival Connective Tissue Graft from Maxillary Tuberosity: A Randomized, Controlled Clinical Trial.

The goal of plastic periodontal surgery is to obtain complete root coverage, increasing gingival thickness (GT), a positive prognostic factor for gingival margin stability over time. The aim of this study was to compare the effectiveness of the Coronally Advanced Flap (CAF) in RT1 (GR; gingival recession with no loss of interproximal attachment) when associated with a connective tissue graft from the maxillary tuberosity (tCTG) or with leukocyte and platelet-rich fibrin (L-PRF) membranes in obtaining root coverage and increasing the thickness and width of the keratinized tissue, along with aesthetic improvement, taking into account a number of patient-related outcomes. Thirty patients with two adjacent RT1 GRs (GRs with no loss of interproximal attachment) were each treated using CAF associated with tCTG (15 patients) or L-PRF. The main outcome was a GT increase; secondary outcomes were keratinized tissue width (KT), gingival recession (GR), probing depth (PD), clinical attachment level (CAL), root coverage percentage (RC%), complete root coverage (CRC), and root coverage esthetic score (RES). Patient-reported outcomes were discomfort (D), dentine hypersensitivity (DH), patient-related esthetic score (PRES), and overall treatment satisfaction (OTS). After 12 months, clinical and patient-reported parameters did not show significant differences between groups, with the only exception being a GT gain, which was significantly greater in the CAF + tCTG group. Our results showed that both techniques were effective in treating RT1 GRs, with comparable patient-related outcomes. However, the use of tCTG produces significantly thicker tissue, covering the exposed root surface.

A novel clinical protocol for dentin hypersensitivity management based on regenerative dental gel associated with calcium: A case study in a patient with periodontal disease

Introduction: Dentin hypersensitivity (DH) is defined as pain caused by dentin exposure in response to various stimuli. Patients with periodontal disease (PD) frequently report DH due to root surface exposure or after periodontal treatment. Bioactive agents derived from calcium and/or silicon-based systems, such as REFIX technology, have been used to promote tooth regeneration, with focus on tooth sensitivity treatment. Case Report: Based on this, the efficacy of REFIX gel combined with calcium on the treatment of a DH was evaluated in a PD 45-year-old male patient. The patient’s right and left sides were randomly selected to use one of the prophylaxis dental protocols: REFIX dental gel/calcium (RDGCa) (experimental: 13, 14, 15 teeth) or Pumice Stone (PS) (control: 23, 24, 25 teeth). The products were applied using dental polishing brush during 10 seconds in each tooth surface. Schiff Air Index (SAI) for sensitive teeth (0–3) were performed by applying air jet to each tooth’s vestibular surface for 5 seconds after and before the prophylaxis. The patient reported pain and interruption of the stimulus before and after PS prophylaxis (SAI 3 and 3 respectively). There was a reduction in pain when RDGCa protocol was used (SAI 3—before/SAI 1—after). In this instance, the patient felt the stimulus but did not request to be interrupted. This contrasted with the outcomes of the initial stimulus as well as PS. Conclusion: The results showed that the RDGCa strategy was successful in lowering DH in PD patients.

The prevalence and common risk indicators of root caries and oral health service utilization pattern among adults, a cross-sectional study.

Root caries is a prevalent oral health concern among adults, yet there remains a need for a comprehensive understanding of its occurrence and associated risk indicators. The present study was aimed to investigate the prevalence of root caries and to determine significantly associated indicators with it among adults. The residents aged 35-74 years old were enrolled in a cross-sectional study in which dental examination were taken and structured questionnaires were collected in Zhejiang Province, China. All data were recorded in an electronic system and analyzed. The prevalence of decayed and filled root caries in 1,076 respondents was 31.9%. Elder age, greater attachment loss, and exposed root surface were associated with higher odds of incidence for decayed/filled roots and decayed roots. In the last 12 months, 27.4% of adults with decayed or filled roots and 23.2% of others utilized oral health services. Carious adults who had a very poor/poor oral health status were 2.905 times likely to report dental visits. People with sound roots who were female (OR = 2.103, P < 0.001), perceived their oral health status as moderate (OR = 1.802, P = 0.015), or poor/very poor (OR = 4.103, P < 0.001) were more likely to visit a dentist in the past 12 months. Age, attachment loss and root exposure were most significantly associated with the prevalence of root caries. Individuals who recognize their poor or very poor oral health status should feel encouraged to make use of oral health services.

Treating hypersensitivity in older adults with silver diamine fluoride: A randomised clinical trial

ObjectiveThis study aimed to evaluate the desensitizing effect of topically applied 38% silver diamine fluoride (SDF) solution on the exposed root surface of hypersensitive teeth in older adults. MethodThis double-blind randomised clinical trial recruited healthy older adults with dentine hypersensitivity. A trained examiner tested the most hypersensitive tooth root surface with a blast of compressed cold air from a three-in-one syringe. The participants gave a sensitivity score (SS) in visual analogue scale from 0 (no pain) to 10 (agonizing) at the baseline visit. Then, they received 38% SDF or 5% potassium nitrate solution (control) as intervention on the root surface. After the intervention, they received a compressed cold air test and reported the SS again. The compressed cold air test followed by intervention was repeated at 4- and 8-week follow ups. The primary outcome was the reduction in SS at 8-week follow-up with reference to the SS at baseline before intervention. Shapiro–Wilk and Mann–Whitney U tests were performed for data analysis following a normality test of SS. ResultsThis trial recruited 148 participants, and 139 (94%) participants completed the trial. The median percentage reductions in SS in the SDF and potassium nitrate groups were 60% and 50%, respectively (p < 0.001). ConclusionAccording to the results, 38% SDF solution reduced hypersensitivity on the exposed root surface of older adults. In addition, 38% SDF was more effective than 5% potassium nitrate solution to reduce hypersensitivity on the exposed root surface of older adults. Clinical significanceDentin hypersensitivity is common amongst older adults and negatively affects their quality of life. To date, there is no gold standard professionally applied desensitizing therapy in treating hypersensitivity. Evidence from this clinical trial could aid clinical practice and improve oral health in older adults. Trial registrationThis study was registered at ClinicalTrials.gov (NCT05392868).

Diode Laser-Assisted Bridge Flap

Mucogingival problems are associated with recession of gingival margin, shallow vestibular depth, and gingival margin pull by aberrant frenum. Till now, various individualistic and successful surgical techniques have been described in the literature for mucogingival problems. These case series enumerate the gingival recession cases, managed by bridge flap technique using diode laser which is a single-step procedure to cover the earlier exposed root surfaces and extend the width of the attached gingiva. Postsurgical parameters were recorded at 6 months and 1 year.

Evaluation of Root Coverage Procedures Using Root Coverage Esthetic Score System – A Case Series

ABSTRACT Background: Gingival recession, characterized by root surface exposure due to apical gingival margin migration, is a prevalent condition in the general populace, frequently prompting patient intervention. Mucogingival therapy may be indicated for recession control, plaque management, and dentin hypersensitivity; nevertheless, the consideration of esthetics correction as a therapeutic rationale is increasingly significant in contemporary clinical practice. Objective: The goal of this case series was to evaluate the most esthetic root coverage procedure of the three procedures performed. Methods: Patients with localized recession were treated with three different root coverage procedures, namely the free gingival graft (FGG), connective tissue graft + coronally repositioned flap (CTG + CAF), and platelet-rich fibrin (PRF) + coronally positioned flap. The root coverage procedures were assessed for the root coverage esthetic score (RES) system after 6 months. The RES scores of these procedures were compared to determine if one procedure offered a greater esthetic result over the other. Results: All three procedures were effective in obtaining root coverage and improved clinical parameters. However, CTG with CAF, along with complete root coverage (CRC), produced a better esthetic outcome than other root coverage procedures compared in this case series. The success of root coverage procedures is based on the overall esthetic outcome along with CRC. Thus through the incorporation of the RES into everyday clinical practice, clinicians can enhance the accuracy and consistency of their evaluations, leading to improved patient care and optimizing treatment planning.

Re-understanding the role of enamel matrix proteins in periodontal regeneration

Enamel matrix proteins (EMP) are deposited on the surface of developing roots before dentin formation and may play a role in osteogenesis. Amelogenins (Am) are the main and active component in EMPs. Studies had showed great clinical values of EMPs in periodontal regenerative treatment and other fields. By affecting the expression of growth factors and inflammatory factors, EMPs could act on various periodontal regeneration-related cells to promote angiogenesis, anti-inflammation, bacteriostasis and tissue healing, achieving the clinical effect of periodontal tissue regeneration (newly generated cements and alveolar bones as well as functionally penetrated periodontal ligament). EMPs alone or combined with bone graft material and barrier can be used for regenerative surgical treatment in intrabony defects and degree Ⅱ furcation-involved at maxillary buccal or mandibular teeth. EMPs can also be adjunctively used to treat recession type 1 or 2 gingival recessions, forming periodontal regeneration on the exposed root surface. Through a comprehensive understanding of the principle and current clinical application of EMPs on periodontal regeneration, we can look forward to their future development. The development of recombinant human amelogenin to replace animal-derived EMPs through bioengineering technologies, the study of the clinical application of EMPs combined with other collagen biomaterials, and the specific application of EMPs in severe soft and hard periodontal tissue defects and peri-implant lesions are all important development directions of future EMPs-related researches.

The Evaluation of Medical Records of Gingival Recession in Chronic Periodontitis Patient

Background: Periodontitis is inflammation of the gingiva accompanied by alveolar bone loss, which causes loss of attachment. Local factors that can exacerbate periodontitis are gingival recession, a condition where the gingival margin is pulled away from the cemento-enamel junction (CEJ), resulting in the opening of the root surface that was initially closed. Objective: This study aimed to determine the distribution of gingival recession features in chronic periodontitis patients at the Universitas Trisakti Dental Hospital, Indonesia. Material and Methods: This type of research is an observational descriptive with a cross-sectional research design with periodic medical record samples from January 2013 to December 2017. Data obtained from medical records were recorded and grouped in tables and then analyzed manually. Results: Of the 583 periodontal patients, there were 311 patients with gingival recession consisting of 11 maxillary gingival recession patients, 21 mandibular gingival recession patients with the majority of mild classification of gingival recession (3.0 mm from the exposed root surface) and 279 patients suffering from in both jaws with the majority classification of severe gingival recession ( 4.0 mm exposed root surface). Conclusion: Gingival recession in patients with chronic periodontitis is more common in the mandible than the maxilla. Patients with chronic periodontitis mostly experience gingival recession of more than 1 tooth in the upper and lower jaw with severe classification ( 4 mm).

Nifedipine attenuates alveolar bone destruction and improves trabecular microarchitectures in mice with experimental periodontitis.

Studies have shown that nifedipine exerts anti-inflammatory and immunosuppressive actions in addition to being a calcium channel blocker. The present study was performed to explore the influence of nifedipine on alveolar bone destruction in mice with experimental periodontitis by evaluating morphological information acquired from micro-computed tomography analysis. BALB/c mice were randomly assigned into four groups: control (C) group; experimental periodontitis (E) group; experimental periodontitis + 10mg/kg dose of nifedipine (EN10) group; and experimental periodontitis + 50mg/kg dose of nifedipine (EN50) group. Periodontitis was induced by oral inoculation with Porphyromonas gingivalis over a 3-week time period. Nifedipine significantly mitigated the loss of alveolar bone height as well as increase of root surface exposure induced by experimental periodontitis. Additionally, the reduction in the bone volume fraction associated with P. gingivalis infection was significantly recovered upon nifedipine treatment. Further, nifedipine attenuated P. gingivalis-induced deteriorations in the trabeculae-associated parameters. Significant difference was evident between Groups EN10 and EN50 in both the extent of alveolar bone loss and microstructural parameters assessed, except trabecular separation and trabecular number. Nifedipine appeared to have good performance in ameliorating bone loss in mice with induced periodontitis. Nifedipine may be utilized in the clinical management of periodontitis, though further research is indicated to verify the therapeutic effect.

Impact of Different Chelating Agents on Fibrin Clot Adhesion to the Exposed Root Surface: A Comparative Study

Impact of Different Chelating Agents on Fibrin Clot Adhesion to the Exposed Root Surface: A Comparative Study

Digitally measured exposed root surface area for predicting the effectiveness of modified coronally advanced tunnel combined de-epithelialized gingival grafting in the treatment of multiple adjacent gingival recessions.

To assess the predictive value of baseline digitally measured exposure root surface area (ERSA) on the effectiveness of modified coronally advanced tunnel and de-epithelialized gingival grafting (MCAT + DGG) technique for the treatment of multiple adjacent gingival recessions (MAGRs). A total of 96 gingival recessions (48 RT1 and 48 RT2) from 30 subjects were included. ERSA was measured on the digital model obtained by intraoral scanner. Generalized linear model was used to analyze the possible correlation of ERSA, Cairo recession type (RT), gingival biotype, keratinized gingival width (KTW), tooth type, and cervical step-like morphology on the mean root coverage (MRC) and complete root coverage (CRC) at 1-year after MCAT + DGG. The predictive accuracy of CRC is tested using receiver-operator characteristic curves. At 1-year postoperatively, the MRC for RT1 was 95.14 ± 10.25%, which was significantly higher than 78.42 ± 22.57% for RT2 (p < 0.001). ERSA (OR:1.342, p < 0.001), KTW (OR:1.902, p = 0.028) and lower incisors (OR:15.716, p = 0.008) were independent risk factors for predicting MRC. ERSA and MRC showed significant negative correlation in RT2(r = -0.558, p < 0.001), but not in RT1(r = 0.220, p = 0.882). Meanwhile, ERSA (OR:1.232, p = 0.005) and Cairo RT (OR:3.740, p = 0.040) were independent risk factors for predicting CRC. For RT2, the area under curve was 0.848 and 0.898 for ERSA without or with other correction factors, respectively. Digitally measured ERSA may provide strong predictive values for RT1 and RT2 defects treated with MCAT + DGG. This study demonstrates that digitally measured ERSA is a valid outcome predictor for root coverage surgery, especially applicable for predicting RT2 MAGRs.

Tunnel vs. coronally advanced flap in combination with a connective tissue graft for the treatment of multiple gingival recessions: a multi-center randomized clinical trial

ObjectiveTo evaluate the efficacy of the partial-thickness non-advanced tunnel technique (TUN) versus the coronally advanced flap (CAF), both combined with a connective tissue graft, in the treatment of multiple gingival recessions.Materials and methodsTwenty-nine patients (83 teeth) affected by multiple gingival recessions were treated in two clinical centers with either the test (TUN) or the control (CAF) intervention combined with a connective tissue graft. Outcomes at 3 and 6 months after surgery included complete root coverage (CRC—primary outcome), mean root coverage (mRC), changes in recession depth (RD), probing pocket depth (PPD), and keratinized tissue height (KT). Root sensitivity and root coverage esthetic score (RES) were also evaluated at 6-month examination. Surgery duration, wound healing index (WHI), and patient-reported outcome measures (PROMs) were additionally considered.ResultsAt 6 months, CRC was observed in 80.9% and 79.5% of the teeth treated with TUN and CAF, respectively (odds ratio = 1.2; p = 0.802). No differences between groups were also observed in terms of mRC (TUN = 94.0%; CAF = 91.1%), RD and PPD reductions, root sensitivity, RES, and WHI. KT increase was significantly higher in teeth treated with TUN (Difference in Means – MD = − 1.0 mm; p = 0.001). Surgery duration was shorter (MD = − 19.3 min; p = 0.001), and patients reported less intra-surgical pain (MD = − 16.4; p = 0.028) as well as postoperative morbidity in TUN compared with CAF.ConclusionsBoth surgical interventions showed a similar efficacy in terms of root coverage, albeit TUN was associated with a higher increase in KT and with a milder patient’s surgical experience.Clinical relevanceBoth techniques have shown similar efficacy for the coverage of exposed root surfaces, although clinicians may consider TUN as less invasive.Trial registrationClinicaltrials.gov (NCT05122468)

Efficacy of a four-curvature auxiliary arch at preventing maxillary central incisor linguoclination during orthodontic treatment: a finite element analysis

BackgroundCorrect torque of the incisors is beneficial in the assessment of the effects of orthodontic treatment. However, evaluating this process effectively remains a challenge. Improper anterior teeth torque angle can cause bone fenestrations and exposure of the root surface.MethodsA three-dimensional finite element model of the maxillary incisor torque controlled by a homemade four-curvature auxiliary arch was established. The four-curvature auxiliary arch placed on the maxillary incisors was divided into four different state groups, among which 2 groups had tooth extraction space retracted traction force set to 1.15 N. Initial displacements and pressure stresses of the periodontal tissue in the maxillary incisors and molars were calculated after torque forces (0.5, 1, 1.5, and 2 N) were applied to the teeth at different stable states.ResultsThe effect of using the four-curvature auxiliary arch on the incisors was significant but did not affect the position of the molars. Given the absence of tooth extraction space, when the four-curvature auxiliary arch was used in conjunction with absolute anchorage, the recommended force value was < 1.5 N. In the other 3 groups (i.e., molar ligation, molar retraction, and microimplant retraction groups), the recommended force value was < 1 N. The application of a four-curvature auxiliary arch did not influence the molar periodontal and displacement.ConclusionA four-curvature auxiliary arch may treat severely upright anterior teeth and correct cortical fenestrations of the bone and root surface exposure.

A COMPARATIVE EVALUATION OF VESTIBULAR INCISION SUBPERIOSTEAL TUNNEL ACCESS (VISTA) VERSUS CORONALLY ADVANCED FLAP WITH COLLAGEN MEMBRANE FOR THE TREATMENT OF MILLERS CLASS I AND CLASS II GINGIVAL RECESSION: A CLINICAL STUDY

Background: Gingival recession is defined asThe displacement of soft tissue margin apical to CEJ with exposure of root surface. Factors such as abnormal tooth alignment in the arch, fenestration, dehiscence, faulty tooth brushing, periodontal diseases etc. are few of the causes of gingival recession. The aim of the present study was to compare the effectiveness of minimally invasive Vestibular Incision Subperiosteal Tunnel Access (VISTA) technique and coronally advanced flap using a bioresorbable collagen membrane in Millers Class I and II gingival recessions Material and Methods: 20 sites with Millers Class I or II gingival recession were recruited and allocated into 2 groups with 10 sites each. Test group: VISTA with bioresorbable collagen membrane control group: CAF with bioresorbable collagen membrane. Plaque Index (PI), Gingival Index (GI), relative Clinical attachment level (CAL) Pocket Probing Depth (PPD) Recession Height (RH) and width of keratinized gingiva (WKG) Recession Width (RW) were measured at baseline 3 months and 6 months. Results: A significant improvement was found in all the clinical parameters in the Test group from baseline to 3 months and 6 months Recession width reduction was significantly more in the Test group as compared to Control group. Conclusion: Both the groups, viz: VISTA with resorbable collagen membrane and CAF with resorbable collagen membrane were effective in the treatment of Millers Class I and II gingival recessions VISTA being minimally invasive can be used for covering recession defects.

Bridge Flap for the Treatment of Multiple Gingival Recession

Because of aesthetic concerns or root sensitivity, gingival recession in anterior teeth is frequently of concern. For aesthetic reasons, gingival recession is extremely concerning, particularly in cases when there are several anterior teeth involved. Root coverage is possible by a variety of mucogingival procedures. This case study introduces a novel bridge flap technique that enables the dentist to enlarge the zone of attached gingiva while simultaneously covering the previously exposed root surfaces. A root coverage procedure was done in this instance to address a multiple recession type defect using a coronally advanced flap and vestibular deepening approach. To widen the associated gingiva in this instance, vestibular deepening technique is employed. An aesthetically healthy periodontium, increased keratinized tissue, and positive patient acceptance are all outcomes of this procedure's predictability.