Treatment Of Gingival Recession Research Articles

Treatment of multiple adjacent gingival recessions using leucocyte- and platelet-rich fibrin with coronally advanced flap: a 12-month split-mouth controlled randomized clinical trial.

This split-mouth randomized study aimed to assess efficacy of leucocyte-platelet-rich fibrin (L-PRF) versus connective tissue graft (CTG) in achieving root coverage (RC) for multiple adjacent gingival recessions (MAGRs) throughout 12-month period. The study enrolled 59 teeth from 12 patients with Miller Class I MAGRs ≥ 2mm on bilateral or contralateral sides. Patients were randomly assigned to receive coronally advanced flap (CAF) with either CTG (control) or L-PRF (test) treatment. Various parameters, including plaque and gingival index, clinical attachment level, recession depth, probing depth, recession width (RW), papilla width (PW), keratinized tissue width (KTW), gingival thickness (GT), percentage of RC, complete root coverage (CRC), and location of the relative gingival margin concerning the cemento-enamel junctions (GMCEJ) after CAF, were recorded at baseline, 3-, 6-, and 12-months post-surgery. On June 29, 2021 the study was registred to ClinicalTrials.gov (NCT04942821). Except KTW and GT gain, all clinical parameters, RC, and CRC were similar between the groups at all follow-up periods (p > 0.05). The higher GT and KTW gains were detected in the control group compared to test group at 12 months (p < 0.05). Both RC and CRC were positively associated with initial PW and GMCEJ, but negatively with initial RW (p < 0.05). The current study concludes that L-PRF were equally effective as CTG in treating MAGRs in terms of RC and CRC. Additionally, RC and CRC outcomes appeared to be influenced by GMCEJ, PW, and RW. L-PRF could represent a feasible substitute for CTG in treating MAGRs.

THE EFFECTIVENESS OF PLATELET RICH FIBRIN, CONNECTIVE TISSUE GRAFT AND THEIR COMBINATION IN THE CLOSURE OF GINGIVAL RECESSION: A SYSTEMATIC REVIEW

Introduction: Connective Tissue Graft (CTG) is one of the techniques in gingival recession treatment, but considering the morbidity of using CTG, biomaterials such as Platelet Rich Fibrin (PRF) can be an alternative in gingival recession closure treatment. This systematic review aims to compare and evaluate the use of PRF, CTG and their combination in gingival recession closure. Review: An electronic literature search in Medline (PubMed), Google Scholar, and Elsevier (Sciencedirect) was conducted to identify Randomized Clinical Trial (RCT) reporting on the treatment of gingival recession using PRF, CTG or a combination of both from 2018 to 2023 in English. This systematic review was conducted following the Preferred Reporting Items for Systematic review (PRISMA) guidelines. The parameters assessed in the RCTs were: recession depth (RD), clinical attachment level (CAL), keratinized gingival width and height (KTW, KTH), probing depth (PD), gingival thickness (GT) and patient discomfort after surgery assessed by VAS (Visual Analog Scale). Based on the 1,152 articles retrieved, there were only five RCTs eligible for systematic review. Four articles compared the use of PRF with CTG, and one article compared the use of CTG with the combination of CTG + PRF in gingival recession closure. Conclusion: The use of PRF, CTG, and a combination of both were effective in closing gingival recession. The use of CTG gave better results in increasing gingival thickness and keratinized gingival width compared to the use of PRF, but the combination of CTG and PRF gave significant results in keratinized gingival height and decreasing recession depth compared to the use of CTG alone. Thus, the combination of CTG and PRF may be a more promising gingival recession closure treatment option.

Gingival Recession. Part 2: Treatment Options and When to Intervene Surgically

This is the second article in a two-part series on gingival recession. The first article covered the aetiology and prevalence of gingival recession, while this article focuses on the factors affecting decision making and the management, including treatment of gingival recession alongside the evidence base. With more than half of the population suffering from gingival recession, the clinician should be aware of the different options and treatment modalities available to manage gingival recession. This will enable them to engage with the patient, giving them the necessary and required information to make a patient-centred decision about the most suitable treatment option that will address their concerns. CPD/Clinical Relevance: The clinician should be aware of the different options and treatment modalities available to manage gingival recession.

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.

The Influence of Root Prominence on the Onset of Gingival Recession: A Systematic Review

This systematic review aimed to identify, evaluate, and summarize the results of relevant studies on radicular prominence and its relationship with gingival recessions. This review was conducted according to the PRISMA (Preferred Reporting Reviews and Meta-Analysis) guidelines, and the focused PICO question was “In teeth with vestibular site-specific root or alveolar bone prominence, what are the chances that this will lead to gingival recession or difficulty in root coverage procedures, compared to teeth correctly positioned in the alveolar bone or without anatomical root prominence?”. A search was carried out on three databases: Embase, PubMed/MedLine, and Wiley Library. This initial search was complemented with manual research. It included any clinical study, such as a randomized clinical trial, controlled clinical trial, prospective/retrospective clinical study, case series, or case report, published in English from January 2012 to December 2023, which reported any involvement of the root/bone prominence approach. The exclusion criteria were clinical studies without report results/details of the case(s), studies based on questionnaires, editorial letters, any review, in vitro/in silica and animal studies, and interviews. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement was applied for quality assessment. A total of 163 articles were found, but only three articles were included (k = 0.98). The included studies observed negative correlations when comparing the variables root prominence with linear root coverage, root surface area covered, and linear tissue thickness gain. It suggested a significant reduction in root coverage for prominences greater than 1 mm; therefore, relevant keratinized tissue gains can be achieved in gingival recession treatment after the application of the odontoplasty. The STROBE checklist evaluated 22 items, and all the included studies had a high-quality assessment (greater than 75%) with values greater than 85%. Then, it was not possible to draw conclusions due to the number of articles included, even though they had high-quality assessments. Otherwise, it is possible to suggest that the root prominence may impact gingival recession. Therefore, new and well-designed studies must be developed to establish a significant conclusion about this condition.

The Treatment Of Miller’s Class I Gingival Recession Implementing The Modified Coronally Advanced Tunnel Technique (MCAT) And Acellular Dermal Matrix (ADM)

Background: Gingival recession can lead to root hypersensitivity, root caries, and impaired aesthetic concerns. Modified coronally advanced tunnel (MCAT) technique, which possesses various benefits that can be used to support the success in the treatment of gingival recession. Acellular dermal matrix (ADM) is used in the procedure, frequently documented indicating encouraging results in the treatment of gingival recession. The following case report is to indicate an evaluation on the treatment utilizing MCAT with ADM. Case presentation: A male of 27 year-old arrived with main complaints of aesthetic concerns and dental hypersensitivity on the upper right teeth posterior caused by Miller’s class I gingival recession. The aforementioned technique is chosen in treatment considering the rate of success to treat the defects as the impact of gingival recession. Case management: The MCAT with ADM commenced with the fabrication of composite stops at the contact points. Later local anaesthesia (lidocaine HCl 2% with epinephrine 1:100,000) was given. Intrasulcular incision was then made and the mucoperiosteal flap was raised with tunneling knives. The tunnel was then extended over the mucogingival junction. ADM was pulled into the tunnel by means of mattress sutures. Finally the tunnel was positioned coronally to the CEJ by means of suspended sutures placed around the contact points. Conclusion: The use of MCAT technique with ADM (Mucoderm) is able to show satisfying outcome with the improvement of root coverage in the case of Miller’s class I gingival recession.

Efficacy of Fibro-Gide® in coronally advanced flap for the treatment of multiple gingival recession: A prospective clinical study

Abstract Aim: The study aims to compare connective tissue graft (CTG) with Fibro-Gide® as an adjunct to the coronally advanced flap (CAF) technique for treating class I and class II gingival recession based on Miller’s classification. Materials and Methods: A total of 30 participants with bilateral Miller’s class I or class II multiple gingival recession contributing to 60 multiple gingival recession sites were enrolled in this prospective clinical study. Recession sites were categorized into two groups. Group 1 (CAF+ CTG; n = 30 sites) and group 2 (CAF+ Fibro-Gide®; n = 30 sites). Clinical parameters, such as gingival recession depth (GRD), probing depth (PD), clinical attachment level (CAL), gingival recession width (GRW), and keratinized tissue (KT) were evaluated at baseline, 3 months, and 12 months. Statistical analysis was performed for intergroup comparison using an independent t test and for intra-group comparison using paired t test. Results: At baseline, the mean GRD for groups 1 and 2 were 3.5 ± 0.8 and 3.4 ± 0.8, whereas GRW for group 1 and group 2 were 3.1 ± 0.1 and 3.1 ± 0.2 respectively. At 12-month follow-up, the reduction in GRD and GRW was statistically significant. The gain of KT accounted to 3.9 ± 5.5 and 3.0 ± 0.8 in group 1 and group 2, respectively, but CAL showed a significant decrease from 5.4 ± 1.02 and 5.4 ± 1.03 to 2.3 ± 0.7 and 2.4 ± 0.7 in group 1 and group 2, respectively. Conclusion: Fibro-Gide® along with CAF improved gingival recession in terms of depth and width as comparable with those of CTG. In terms of KT, CTG has better long-term stability than Fibro-Gide® when combined with the CAF technique in treating multiple gingival recessions.

Efficacy of acellular xenogeneic dermal matrix graft in the treatment of multiple gingival recessions: systematic review and meta-analysis.

This study aimed to compare the efficacy of acellular xenogeneic dermal matrix graft (AXDM) compared to connective tissue graft (CTG) in treating multiple gingival recessions. A systematic search of electronic databases was conducted to identify randomized clinical trials (RCTs) that compared AXDM and CTG. The selected studies were subjected to bias risk assessment, data extraction, and meta-analyses. Parameters such as gingival recession height, width, mean percentage of root coverage, and complete root coverage were analyzed. Seven RCTs involving 146 patients were included. The meta-analyses indicated that CTG was statistically superior to AXDM in reducing gingival recession height at the final follow-up (mean difference: -0.104mm, 95% confidence interval [CI]: -0.180-0.028, p = 0.008) and width at the final follow-up (mean difference: -0.285mm, 95% CI: -0.541-0.030, p = 0.029). CTG also demonstrated a significantly higher mean percentage of root coverage at the 6-month follow-up (difference in means: -2.761mm, 95% CI: -4.932-0.590, p = 0.013) and a higher percentage of complete root coverage at the 6-month follow-up (odds Ratio [OR]: 0.598, 95% CI: 0.4-0.892, p = 0.012) compared to AXDM. However, there was no significant difference in the number of teeth with complete root coverage between CTG and AXDM (OR: 1.610, 95% CI: 0.983-2.636, p = 0.058) and aesthetic outcomes (mean difference: 0.148, 95% CI: -0.277-0.573, p = 0.494). CTG is more effective than AXDM in treating multiple gingival recessions. This is evidenced by significant reductions in gingival recession height and width, a higher mean percentage of root coverage, and a greater percentage of complete root coverage at the 6-month follow-up. In some clinical situations an alternative to CTG is required for the treatment of multiple gingival recessions. AXDM, despite presenting clinical outcomes that are not as satisfactory as CTG, can be used for this purpose.

Gingival recession: how to choose the best surgical technique?

Objective: to present the main decision -making criteria when choosing a surgery technique for the most variety forms of gingival recession. Data sources: A bibliographic review was carried out with a search in the database: VHL Odontologia, Scielo and Pubmed on the subject. Data synthesis: the fundamental criteria for determining the best surgery Technique I'm be used in the treatment of gingival recessions are: the classification of recessions , the location of the recession ( maxilla or mandible ), the fact that it is single or multiple , the presence or absence of keratinized apical or lateral gingiva _ the recession, the thickness characteristic of the periodontal (periodontal biotype) and the skill of the operator. Conclusions: the choice of surgery technique, with the objective of root coverage, must follow a careful assessment of clinical findings, diagnosis and operator skill. This increases the predictability of success of the surgery therapy I'm be used.

Evaluation of the Clinical Efficiency of Tunnel Technique and Modifications in the Treatment of Gingival Recessions

Dişeti çekilmesi (DÇ), dişin gingival kenarının mine-sement sınırının apikalinde konumlanması sonucu kök yüzeyinin ağız ortamına açılması olarak tanımlanır. Dişeti çekilmesinin patolojik, fizyolojik, anatomik veya bunların kombinasyonları sebebiyle oluşabileceği ile ilgili farklı düşünceler vardır. Son yıllarda hastaların yüksek estetik beklentilerini karşılamak ve kanlanmayı artırmak gibi sebeplerle papillanın bütünlüğünü koruyan cerrahi prosedürler ön plana çıkmaktadır. Periodontal biyotipi geliştirmek için bir otogreft olan bağ dokusu grefti(BDG) altın standarttır. Tünel tekniği (TUN), konservatif özellikleri ve gelişmiş estetik sonuçları sayesinde sıkça gündeme gelmektedir. Bu yöntem teknik hassasiyeti oldukça yüksek olan olan Modifiye Koronale Pozisyone Tünel Tekniği (MKPTT), Vestibuler İnsizyon Subperiosteal Tünel Tekniği (VISTA), modifiye-Vestibuler İnsizyon Subperiosteal Tünel Tekniği (m-VISTA ) ve Lateral Tünel Tekniği (LTT) modifikasyonların ortaya çıkmasına aracı olmuştur. Son yıllarda çokça uygulanan BDG ve/veya greft benzeri materyallerin kullanımı hasta konforunu artırmaktadır. Bu greft benzeri materyaller sığır/domuz kaynaklı kolajen matriks(KM), hiyalüronik asit(HA), trombositten zengin fibrin(TZF) olabilmektedir. Bu materyaller ile kullanılan çalışmaların sonuçları umut verici görünmektedir. LTT, tekli dişeti çekilmelerinin tedavisinde oldukça başarılı bulunmuştur. MKPTT hem tekli hem de çoklu dişeti çekilmelerinin tedavisinde kök kapama yüzdesi ve keratinize dişeti genişliğinin artırılmasında en yüksek başarıya sahip yöntem olarak öne çıkmaktadır.

Efficacy of amniotic membrane with coronally advanced flap in the treatment of gingival recession: an updated systematic review and meta-analysis

ObjectivesThis systematic review aims to evaluate the efficacy of combining the amniotic membrane (AM) with the coronally advanced flap (CAF) in the treatment of Miller class I and II gingival recession (GR).MethodsThe protocol of this updated PRISMA-compliant systematic review was registered in PROSPERO (CRD42023431501). The following treatment outcomes were recorded; recession depth (RD), recession width (RW), width of keratinized gingiva (WKG), and clinical attachment level (CAL). We searched the following databases: MEDLINE, Cochrane Library, Google Scholar, EMBASE, Web of Science, and Science Direct.ResultsTwo independent reviewers screened the selected articles. Twenty-two eligible articles were extracted, with 689 sites of GR in 481 patients. No statistically significant difference was found in RD, RW, WKG, and CAL between (AM&CAF) in comparison to control groups. However, the subgroup analysis showed statistically significant differences in RD between the (AM & CAF) group v/s (CAF) alone (P = 0.004). Moreover, the subgroup analysis of the WKG showed statistically significant differences between (AM & CAF) v/s (CAF&CM) (p = 0.04). Additionally, a statistically significant difference was found in the subgroup analysis of CAL between both (AM & CAF) group v/s (CAF) alone (p = 0.0009).ConclusionWith the limitations of this meta-analysis due to short follow-up periods (6 months), the AM can be considered a viable treatment option for GR defects with satisfactory treatment outcomes comparable to other previously investigated treatment modalities.Clinical significanceWhile AM showed various beneficial properties as an ideal membrane for the coverage of GR, future studies are required to completely understand the potential application of AM in the treatment of GR.

A Novel 3D Tunneling Surgical Technique (3DT) for the Treatment of Gingival Recessions with Reconstruction of the Deficient Interdental Papilla and Interproximal Attachment Regeneration: Case Series.

Current concepts in periodontology emphasize an important distinguishing aspect of the interproximal attachment, assigning its major influential significance as a key diagnostic and prognostic factor. A complete regeneration of the interproximal clinical attachment has become a primary determinant of the periodontal success. Since mid - 20th century have been published numerous articles on root coverage procedures but mostly for non-proximal gingival recessions. When it comes to the interdental area, literature does not inspire the same level of confidence. This study is aimed to introduce an innovative 3D - Tunneling Surgical Technique for the gingival papilla reconstruction and supra-alveolar interproximal attachment regeneration. The technique is described step by step and shown on three selected clinical cases of multiple bilateral adjacent gingival recessions type 2 and 3 in the lower anterior area with follow - up results of up to 6.5 years. A total of 18 proximal, mid-buccal and mid-lingual recessions were treated simultaneously. Mean root coverage up to 88.9% has been achieved in the proximal area. Within its limits, this study demonstrates a possibility of treating gingival recessions with deficient papilla in the mandibular anterior region, achieving a significant clinical improvement with the long-term stability.

Clinical and Aesthetic Evaluation of Minimally Invasive Surgical Therapy for the Treatment of Gingival Recession Defects - A Systematic Review of Randomized Clinical Trials

Background: The concept of minimally invasive dentistry has seamlessly blended into the various fields of dentistry including periodontics. The past three decades have witnessed a paradigm shift from conventional surgical procedures to microsurgery in the field of periodontal plastic surgery. This entails the integration of microsurgical principles, refined surgical skills and magnification devices along with microsurgical instruments. This systematic review of the randomized clinical trials attempts to address the clinical question whether the application of minimally invasive surgical procedures for gingival augmentation and root coverage procedures for the treatment of gingival recession translate into superior clinical and patient oriented results as compared to conventional root coverage procedures. Materials and Methods: Science Direct and Ovid databases, PubMed, Scopus, and Product literature were accessed to review relevant literature evaluating minimally invasive surgery for treatment of gingival recession defects (GRDs). The search covered 13 studies published in medical and dental journals in English with a relevant impact factor and had a follow up of at least 6 months, up to and including June 2023. The results were based on parameters such as complete root coverage (CRC, expressed as percentage), mean root coverage (MRC, expressed as %) width of keratinized tissue (WKT), and variables such as esthetics and pain postsurgery. Results and Conclusion: The 13 studies pooled in 342 patients who underwent root coverage procedures for treatment of GRDs. The test group (microsurgical) and the control group (macrosurgical group) both resulted in overall improvement in parameters like MRC and CRC, WKT etc. at least 6 months postsurgery; however, statistical difference in between both the groups in these parameters was seen in only three studies. There was marked improvement found in the test group after surgery with respect to esthetics (root coverage aesthetic score) and pain scores (Visual Analog Scale score) as compared to the control group. This compels us to infer that although both conventional and microsurgical procedures are successful as root coverage procedures, microsurgical procedures are minimally invasive and produce superior esthetic and comfort parameters for the patient and are therefore highly recommended in surgical procedures.

Effectiveness of the periodontal dressing upon periodontal parameters during treatment of gingival recession by free gingival graft

Background:Various grafting procedures have been used to convert a thin periodontal phenotype to a thick phenotype, including free gingival graft.Objective:To evaluate the effectiveness of the periodontal dressing upon periodontal parameters such as Pocket depth, width of keratinized gingiva and recession depth during treatment of the Miller class I, II or III gingival recession of the lower anterior teeth. Materials andMethods:34 lower anterior teeth with Miller class I, II or III gingival recession were selected and randomly grouped into two groups. The first group included 19 teeth and was treated with a single-step free gingival graft procedure with the application of the periodontal dressing. The second group had 15 teeth and was treated with a single-step free gingival graft (FGG) procedure without applying the periodontal dressing. Clinical parameters such as probing depth, the width of keratinized gingiva and recession depth were recorded before surgery (B0), two weeks (B1) and three months (B2) after surgery. Results:No significant differences (P&gt;0.05) in PD were observed in both groups at different time intervals and between both groups at two weeks and three months after surgery. However, a significant reduction (P&lt;0.05) in RD in both groups at two weeks and three months after the surgery was seen. Also, both groups saw a significant decrease (P&lt;0.05) at two weeks and three months after surgery. WKG was significantly (P&lt;0.05) increased at two weeks and three months after the surgery in both groups. The difference in the increase was highly significant (P&lt;0.001) between both groups at 2-weeks and 3-months after the surgery.Conclusions:The group that used periodontal dressing at 2-weeks and 3-months after surgery reported greater improvements in root coverage and increased width of keratinized gingiva compared to those who did not use periodontal dressing.

Treatment of single gingival recessions using biofunctionalized collagen matrix: A case series

AbstractBackgroundConnective tissue graft substitutes have been used widely to overcome autogenous graft limitations. Nevertheless, they do not provide comparable results in the treatment of periodontal and peri‐implant soft tissue defects. Based on the principles of tissue‐engineered materials, injectable platelet‐rich fibrin (i‐PRF) has been combined with collagen matrices (CMs) to enhance their clinical efficacy. To the best of our knowledge, this is the first case series demonstrating the use of i‐PRF for the biofunctionalization of a volume‐stable collagen matrix (VCMX) as an adjunct to coronally advanced flap (CAF) to treat single gingival recession (GR) defects.Methods &amp; ResultsThe study included 10 patients. Bleeding on probing, probing depth, GR height, clinical attachment level, esthetics, and dentin hypersensitivity were evaluated. After 6 months, a significant GR reduction (RecRed: 2.15 ± 0.7 mm; p = 0.005) and percentage of root coverage (% RC) of 81.13% were observed. Additionally, 40% of the sites showed complete root coverage. Gingival thickness increased 0.64 mm. Patient‐centered evaluations demonstrated dentin hypersensitivity and esthetics improvements by the end of follow‐up.ConclusionVCMX biofunctionalized with i‐PRF associated with CAF technique showed promising clinical outcomes in the treatment of single RT1 GR defects.

Clinical substantiation of the platelet-rich plasma effectiveness in complex surgical treatment of gingival recession

Gingival recession is a non-inflammatory pathological process characterized by apical migration of the marginal gingiva below the CEJ. The use of platelet-rich plasma is one of the current technologies in the complex treatment of gingival recession. The aim of the study was to increase the effectiveness of surgical treatment of gingival recession using platelet plasma. As a result of the treatment of gingival recession I, II and III Millers classes, the coverage area of the recipient surface was 84%, 77% and 60%, accordingly; the thickness of the keratinized gingiva increased by an average of 2 times. The use of platelet plasma in the complex treatment of gingival recession optimizes the healing period in the regeneration phase, improves the microcirculation of periodontal tissues and reduces the duration of treatment by an average of three days; shows more efficiency due to less physiological shrinkage of the graft over time.

Electrospun methacrylated natural/synthetic composite membranes for gingival tissue engineering

New functional materials for engineering gingival tissue are still in the early stages of development. Materials for such applications must maintain volume and have advantageous mechanical and biological characteristics for tissue regeneration, to be an alternative to autografts, which are the current benchmark of care. In this work, methacrylated gelatin (GelMa) was photocrosslinked with synthetic immunomodulatory methacrylated divinyl urethanes and defined monomers to generate composite scaffolds. Using a factorial design, with the synthetic monomers of a degradable polar/hydrophobic/ionic polyurethane (D-PHI) and GelMa, composite materials were electrospun with polycarbonate urethane (PCNU) and light-cured in-flight. The materials had significantly different relative hydrophilicities, with unique biodegradation profiles associated with specific formulations, thereby providing good guidance to achieving desired mechanical characteristics and scaffold resorption for gingival tissue regeneration. In accelerated esterase/collagenase degradation models, the new materials exhibited an initial rapid weight loss followed by a more gradual rate of degradation. The degradation profile allowed for the early infiltration of human adipose-derived stromal/stem cells, while still enabling the graft's structural integrity to be maintained. In conclusion, the materials provide a promising candidate platform for the regeneration of oral soft tissues, addressing the requirement of viable tissue infiltration while maintaining volume and mechanical integrity. Statement of significanceThere is a need for the development of more functional and efficacious materials for the treatment of gingival recession. To address significant limitations in current material formulations, we sought to investigate the development of methacrylated gelatin (GelMa) and oligo-urethane/methacrylate monomer composite materials. A factorial design was used to electrospin four new formulations containing four to five monomers. Synthetic immunomodulatory monomers were crosslinked with GelMa and electrospun with a polycarbonate urethane resulting in unique mechanical properties, and resorption rates which align with the original design criteria for gingival tissue engineering. The materials may have applications in tissue engineering and can be readily manufactured. The findings of this work may help better direct the efforts of tissue engineering and material manufacturing.

Comparative Evaluation of Vestibular Incision Subperiosteal Tunnel Access (VISTA) Technique With and Without Advanced Platelet Rich Fibrin for Treatment of Maxillary Anterior Gingival Recessions.

Gingival recession is an apical shift of the gingival margin with exposure of the root surface to the oral cavity which creates an aesthetic problem. The present study was attempted to compare Vestibular incision subperiosteal tunnel access (VISTA) with and without Advanced platelet rich fibrin(A-PRF) in the treatment of Miller's class I gingival recessions. 24 patients were assigned randomly either to test (VISTA with A-PRF) or control (VISTA alone) group. Clinical parameters like recession depth (RD), recession width (RW), clinical attachment loss (CAL), width of keratinized gingiva (WKG), gingival thickness (GT) and probing depth (PD) were recorded at baseline,3 and 6 months post operatively. Inter group comparison of mean RC in mm, %RC, ΔWKG and CAG revealed no statistically significant difference (p>0.05). Change in GT showed statistically significant improvement in test group. Within the limitations of this study, both treatment options (VISTA with A-PRF and VISTA alone) have resulted in predictable and comparable root coverage with increased gingival thickness in the test group.

Treatment of Maxillary Gingival Recessions Using the Modified Coronally Advanced Tunnel Technique in Combination with a Volume-Stable Collagen Matrix: A Prospective Case Series with a 12-Month Follow-up

The aim of this case series was to evaluate the clinical performance of a new volume-stable collagen matrix (VCMX) in combination with the modified coronally advanced tunnel technique (MCAT) for the treatment of gingival recessions. Thirteen patients with a total of 33 maxillary RT1 single and multiple gingival recessions were included in the study. Probing pocket depth (PPD), recession width (RECW), recession depth (REC), height of keratinized tissue (HKT), and gingival thickness (GT) were assessed at baseline and at the 12-month follow-up. Postoperative healing was uneventful in all cases without any complications. At 12 months, mean root coverage (MRC) was 92.88%, with complete root coverage (CRC) in 87.88% of treated sites. The present findings suggest that VCMX in combination with MCAT results in predictable coverage of maxillary RT1 gingival recessions. Further studies with larger sample sizes and control groups are needed to support these preliminary outcomes.

Amniotic membrane versus platelet-rich fibrin in treatment of gingival recession- a randomized control trial

ObjectiveTo determine the efficacy of latelet-rich fibrin (PRF) and Amniotic membrane (AM) along with the coronally advanced flap (CAF) technique in treating Miller’s class I gingival recession (GR) defects. Material and methodsA total of 32 sites with Miller’s class I GR defects were distributed into Group A (CAF + PRF, n = 16) and Group B (CAF + AM, n = 16). Clinical parameters like gingival index (GI), plaque index (PI), gingival bleeding index (GBI), gingival sulcus depth (GSD), relative attachment level (RAL), and gingival marginal level (GML) were measured at baseline and at 3, 6 and 9 months after surgical intervention. ResultsPRF and AM with CAF were effective treatment modalities for treating Miller’s class I GR defects, with an average root coverage value of 2.00 ± 0.75 mm in Group A and 1.5 ± 0.3 mm in Group B. Complete coverage (100 %) was obtained in 57 % sites of group A and 49 % sites of group B. At the 9-month follow-up, there was a significant increase in relative attachment levels in both groups when compared to baseline. ConclusionIn the present study it was observed that there was a clinically and statistically significant improvement in root coverage with both groups. PRF-treated sites showed > 50 % complete coverage and hence were superior. AM showed comparable results to PRF and could be used as an alternative.