Treatment Of Multiple Recession Defects Research Articles

Coronally advanced flap with connective tissue graft for the treatment of multiple recession defects: Case Report.

Coronally advanced flap with connective tissue graft for the treatment of multiple recession defects: Case Report.

Comparative Evaluation of Recession Coverage Obtained Using the Pinhole Surgical Technique With and Without Platelet-Rich Fibrin: A Randomized Clinical Trial.

This randomized controlled clinical trial evaluated the pinhole surgical technique (PST) combined with platelet-rich fibrin (PRF) for the management of multiple recession defects compared to PST alone. Ten patients with 51 Miller Class I/ II or III gingival recessions were selected. Control sites were treated with PST alone, whereas test sites were treated with PST with PRF. Gingival recession depth (GRD), gingival recession width (GRW), probing depth (PD), clinical attachment level (CAL), keratinized tissue width (KTW), total soft tissue gain (TSTG), Plaque Index (PI), Gingival Index (GI), and gingival bleeding index (GBI) were measured at baseline and at 1, 3, and 6 months posttreatment. Both groups showed statistically significant root coverage. The mean recession coverage was 60.25% in the test group and 49.6% in the control group. The recession reduction from baseline was 2.50 mm for the test group and 1.88 mm for the control group. At the end of 6 months, all sites achieved adequate root coverage. PRF is a feasible alternative to connective tissue grafts as an adjunct to PST for the treatment of multiple recession defects.

Multiple Subperiosteal Sling Sutures for Connective Tissue Graft Stabilization in the Treatment of Multiple Recession Defects Utilizing Subperiosteal Tunnels via VISTA and Intrasulcular Access.

This report describes the utilization of multiple subperiosteal sling (SPS) sutures to stabilize connective tissue grafts in the treatment of multiple recession defects using subperiosteal tunnels via vestibular and intrasulcular accesses. The SPS sutures engage only the graft and stabilize it against teeth inside the subperiosteal tunnel without engaging the overlying soft tissue, which is neither sutured nor coronally advanced. At sites with deep recessions, the graft is left exposed over the denuded root surfaces and allowed to epithelialize, which results in root coverage and increased attached keratinized tissue. Further controlled studies are required to investigate the predictability of this treatment approach.

Vestibular incision subperiosteal tunnel access and multilayered advanced platelet rich fibrin membrane for management of multiple gingival recessions

Treatment of multiple recession defects on the lingual is challenging owing to the site-specific anatomical features of this region. Surgical approaches based on the use of subepithelial connective tissue grafts are considered the “gold standard” for the treatment but represent various complications and morbidity. Various techniques have been suggested for the treatment of multiple adjacent recessions with less patient discomfort and enhanced esthetics. Advanced platelet-rich fibrin (A-PRF) has been shown to promote soft-tissue healing. A-PRF is a fibrin matrix network, in which platelets are trapped and release a high amount of growth factors which take part in soft tissue and hard tissue repair and regeneration. The current case report introduces a novel, minimally invasive predictable approach applicable for both isolated as well as multiple defects with the use of the (vestibular incision subperiosteal tunnel access) technique in combination with a multilayered A-PRF membrane.

MULTIPLE GINGIVAL RECESSION COVERAGE TREATED WITH VISTA TECHNIQUE USING ACELLULAR DERMAL MATRIX (ADM) COMBINED WITH PLATELET RICH FIBRIN (PRF): A CASE REPORT

Background: Gingival recession is an exposure of the root surface due to migration of the marginal periodontal tissues apical to the cemento enamel junction. There are so many root coverage procedures, among these techniques, VISTA technique combined with ADM and PRF offers minimally invasive approach.Case Management: A-40-year-old male visited Periodontics Clinic of DentalHospital Airlangga University with the chief complaint of poor aesthetic resulting from exposed root surfaces in upper right front region of the jaw. Root coverage by VISTA technique using ADM combined with PRF was planned to this case.Discussion: The minimal invasive VISTA technique approach, combined with ADMand PRF has a number of advantages for successful treatment of multiple recession defects. VISTA technique was used because it can maintain better blood supply and maintain critical papillary integrity. ADM works like an autogenous graft by providing a bioactive matrix consisting of collagen, elastin, blood vessel channels, and bioactive protein that support natural revascularization, cell repopulation, and tissue remodeling. Growth factors present in PRF plays a crucial role in hard and soft tissue repair.Conclusion: VISTA technique together with ADM and PRF membrane can besuccessfully used as a treatment method for multiple gingival recessions of Miller’s class I defects

Long‐Term Outcome (10 Years) of Multiple Recession‐Type Defects Treated With Acellular Dermal Matrix Graft and Coronally Advanced Flap: A Case Report

There is limited evidence related to the long-term treatment outcomes of acellular dermal matrix graft (ADMG) plus coronally advanced flap (CAF) for the treatment of multiple recession defects. The aim of this case report is to assess the short- and long-term clinical outcomes of Miller Class I multiple gingival recession-type defects in the maxilla treated with ADMG plus CAF. A 36-year-old female patient smoking < five cigarettes per day presented multiple adjacent Miller Class I gingival recession in the left maxilla and was referred for treatment with chief complaints of dental hypersensitivity and esthetics. Root coverage was achieved by ADMG + CAF and the patient underwent a 10-year follow-up. Within the limits of this case report, mean root coverage obtained at 6 months could not be maintained in the long term. A significant relapse was detected after 10 years, from 80% complete root coverage (CRC) at 6 months to 40% at 10 years. Monitoring, compliance, and reinstructions in oral hygiene techniques seem mandatory for minimizing relapse of gingival recessions after root coverage procedures.

Treatment Of Multiple Adjacent Recession Defects With Zucchelli’s Modified Coronally Advanced Flap With And Without Adjunctive Use Of Platelet Rich Fibrin: A Case Report

When there are multiple recession defects affecting adjacent teeth, patient related considerations suggest the selection of the surgical techniques that allow simultaneous correction of all gingival defects with soft tissue close to the defects themselves. The present case report highlights the effectiveness of Zucchelli’s modified coronally advanced flap with envelope technique along with use of Platelet Rich Fibrin for the treatment of multiple recession defects in patients with aesthetics demands. Key Words Gingival recession, Zucchelli’s modified coronally advance flap, platelet rich fibrin, root coverage

Treatment of multiple recession defects with vestibular incision subperiosteal tunnel access (VISTA): A retrospective pilot study utilizing digital analysis.

To examine the correlation between initial site-specific characteristics of patients with multiple gingival recession defects and the outcome of root coverage therapy. Pretherapy and post-therapy study models of 21 patients (154 teeth) with multiple gingival recession defects, treated with Vestibular Incision Subperiosteal Tunnel Access (VISTA), were optically scanned. Three-dimensional analysis of superimposed preoperative and postoperative images was performed. Linear and surface root coverage were calculated and correlated to various clinical and/or anatomical parameters. A multilevel statistical analysis was conducted, adjusting for the correlation among multiple observations. The mean percentages of linear root coverage were 96.2 ± 13.1% and 84.3 ± 14.4% for Miller Class I/II and Class III recessions, respectively. The mean percentages of root surface area coverage were 92.1 ± 12.0% and 78.6 ± 15.7% for Miller Class I/II and III defects, respectively. Root prominence, initial recession width and posterior tooth type were negatively correlated with linear and root surface area coverage. Initial recession depth was negatively correlated with root surface area coverage. Initial gingival margin thickness was positively associated with both linear and root surface area coverage. The results of the present study identified important positive and negative site-specific characteristics that may have utility in predicting the outcome of root coverage. This study used sensitive 3-dimensional digital analysis tools to examine the correlation between initial site-specific characteristics of patients with multiple gingival recession defects and the outcome of periodontal root coverage therapy. Results demonstrated that initial root prominence, loss of interdental tissue (Miller Class III), molar tooth type, initial recession depth and width were negatively correlated with the outcome of periodontal root coverage achieved. Conversely, initial gingival margin thickness was associated with increased percentage of root coverage. These site-specific characteristics may serve as important risk indicators to predict the outcome of root coverage procedure.

PC204: Er‐Yag assisted protocol for periodontal tissue preparation and treatment of multiple recession defects on maxilla as pre‐orthodontic preparation

PC204: Er‐Yag assisted protocol for periodontal tissue preparation and treatment of multiple recession defects on maxilla as pre‐orthodontic preparation

Mucogingival surgery for treatment of multiple recession defects of gingiva: a case report

Mucogingival surgery for treatment of multiple recession defects of gingiva: a case report

Minimally Invasive Treatment of Mandibular Anterior Lingual Defects by Vestibular Incision Subperiosteal Tunnel Access Technique and Connective Tissue Graft: A Case Report

Introduction: Treatment of recession defects on the lingual surface of mandibular anterior teeth is challenging owing to site‐specific anatomic features of this region. Surgical approaches based on use of subepithelial connective tissue grafts (SCTGs) are considered the “gold standard” for treatment of multiple recession defects. To the best of the authors’ knowledge, this is believed to be the first case report of an attempt to correct lingual recession by SCTG with the minimally invasive vestibular incision subperiosteal tunnel access technique.Case Presentation: A non‐smoking 55‐year‐old male patient presented with hypersensitivity in his mandibular anterior teeth in August 2016. Multiple lingual recession defects were treated by placing a SCTG harvested from the palate underneath the subperiosteal tunnel using a midline access incision. Six months after treatment, a significant increase of root coverage (88.17%), gain in gingival thickness (1.29 mm), and width of keratinized gingiva (1.41 mm) led to a promising outcome and high patient satisfaction.Conclusion: A minimally invasive surgical technique has been presented that can restore the functional properties of lingual gingiva of the mandibular anterior teeth by repairing gingival defects and reestablishing integrity of the zone of keratinized gingiva.

Zucchelli’s Modified Coronally Advanced Flap Technique for the Treatment of Multiple Recession Defects – A Case Report

Zucchelli’s Modified Coronally Advanced Flap Technique for the Treatment of Multiple Recession Defects – A Case Report

RhPDGF Mediated Root Coverage Procedure Using Coronally Advanced Flap in Treatment of Multiple Recession Defects: A Case Report

AbstractGingival recession has been defined as the term used to characterize the apical shift of the marginal gingiva from its normal position on the crown of the tooth to levels on the root surface beyond the cemento-enamel junction (CEJ). Numerous techniques have been developed for treatment of these defects including rotational and advanced gingival flaps, soft-tissue grafting procedures with autogenous and allograft materials. This paper illustrates a case report of 42-years-old male patient with a chief complaint of thermal root sensitivity in relation with front teeth of lower jaw and describes a technique to coronally advance the flap in combination with recombinant human platelet-derived growth factor-BB (rhPDGF-BB) (GEM 21S®) to treat multiple gingival recession defects. Patient was followed postoperatively, and healing was evaluated at 1, 3 and 6 months, with recession depth as the primary outcome measure. This case report revealed a favourable tissue response to GEM 21S® from both clinical and aesthetic points of view showing excellent plastic surgery results for gingiva.

Treatment of multiple recessions by means of a collagen matrix: a case series.

This case series evaluated the use of a collagen matrix with a coronally advanced flap procedure for the treatment of multiple recession defects. Fifteen patients with a total of 80 recession defects were included. Root coverage was 85% ± 13% at 6 months and 81% ± 22% at 12 months. Complete root coverage was achieved in 60% of the sites after 6 months and in 56% after 12 months. The percentage of sites with thick gingival morphotype increased significantly. The results indicated that the collagen matrix may be a useful alternative to the connective tissue graft in the treatment of multiple recession defects.

A mucogingival technique for the treatment of multiple recession defects in the mandibular anterior region: a case series with a 2-year follow-up.

In the mandibular anterior area, gingival recession can be associated with a minimal amount or lack of attached gingiva, a shallow vestibule, and high frenum insertion. These anatomical features may preclude the use of traditional root coverage procedures. This case series describes a a bilaminar technique with flap incision in the fornix for the treatment of adjacent gingival recession defects in patients with a shallow vestibule. It achieved high predictability in complete root coverage without decreasing the vestibular depth. At 24 months, the treatment resulted in 90.6% ±16.8% root coverage, and 11 of the 15 treated teeth (73.3%) were completely covered.

Esthetic Rehabilitation of a Severely Compromised Anterior Area: Combined Periodontal and Restorative Approach

The complete oral rehabilitation of patients demanding a beautiful and attractive smile involves a multidisciplinary approach that includes the change of both the morphological aspect of the teeth and the architecture of gum tissues. This clinical report describes a successful interdisciplinary approach for the treatment of an esthetically compromised dentition. In a first phase, the periodontal plastic surgery was performed for root coverage and, in particular, it was decided for the execution of a coronally advanced flap for the treatment of multiple recession defects. Once complete healing of soft tissues was obtained, six lithium disilicate veneers were placed over the anterior maxillary teeth. Lithium disilicate is a glass-based ceramic which presents excellent aesthetics and allows the passage of light without creating unnatural reflections. This feature has made it possible to recreate a natural aspect of teeth that in combination with the harmonic architecture of soft tissue has permitted obtaining a beautiful and pleasant smile.

Lateral sliding bridge flap technique along with platelet rich fibrin and guided tissue regeneration for root coverage

Gingival recession is defined as the apical migration of the gingival margin with exposure of root surfaces. The etiology of the condition is multifactorial. Given the high rate of gingival recession defects among the general population, it is imperative that dental practitioners have an understanding of the etiology, complications and management of the condition. A recent innovation in dentistry is the preparation and use of platelet-rich fibrin (PRF) for recession defects. The article presents a case report, which highlights the use of lateral sliding bridge flap along with PRF in a collagen membrane carrier (guided tissue regeneration) for the treatment of multiple recession defects.

Zucchelli′s technique combined with platelet-rich fibrin for root coverage

Desire for improved esthetics and the consequent need for cosmetic dentistry have increased tremendously in recent times making esthetic procedures an integral part of periodontal treatment. The treatment of choice for recession coverage should address the biological as well as the patient's esthetic demands. Zucchelli and Sanctis (2000) proposed a modification in the coronally advanced flap technique for treatment of multiple recession defects in esthetic areas. A recent innovation in dentistry is the preparation and use of platelet-rich fibrin for recession defects. This case report highlights the Zucchelli's technique along with the use of PRF for root coverage in multiple recession defects.

Treatment of multiple recession-type defects in patients with esthetic demands.

When multiple recession defects affecting adjacent teeth in esthetic areas of the mouth are present, patient-related considerations suggest the selection of surgical techniques that allow all gingival defects to be simultaneously corrected with the soft tissue close to the defects themselves. The aim of the present study was to evaluate, with respect to root coverage, the effectiveness of a new surgical approach to the coronally advanced flap procedure for the treatment of multiple recession defects in patients with esthetic demands. Twenty-two young systemically and periodontally healthy subjects with at least 2 recession-type defects affecting adjacent teeth in esthetic areas of the mouth were enrolled in the study. All recessions were Miller Class I or II. In each patient, all present recessions were treated at the same time with a modification of the coronally advanced flap technique. The clinical re-evaluation was made 1 year after the surgery. A total of 73 recessions (mean recession depth 2.8 mm) were treated; mean number of gingival recessions in each subject was 3.4. At the 1-year examination, on average, 97% of the root surface was covered with soft tissue and 64 defects (88%) showed complete root coverage. Complete root coverage in all recessions was achieved in 16 out of 22 patients (73%), and no statistically significant relationship was found between the root coverage results and the number of recession defects treated in each patient. A statistically significant increase of keratinized tissue (0.6 mm) was observed after 1 year; this increase was inversely correlated (P <0.001) with the amount of presurgical keratinized tissue. The multiple regression model showed that the final result, in terms of root coverage, was significantly affected by the initial recession depth and by the amount of presurgical keratinized tissue. Greater reductions in recession depth were observed in the cases with worse initial conditions and with lesser amount of keratinized tissue apical to the recession defect. The results of the present study demonstrated that the proposed surgical technique was very effective for the treatment of multiple gingival recessions affecting teeth in esthetic areas of the mouth and that these successful root coverage results could be achieved irrespective to both the number of recessions simultaneously treated during the surgical intervention and the presence, before surgery, of a minimal amount of keratinized tissue apical to the defects.