scholarly journals Laterally Positioned Flap with Subepithelial Connective Tissue Graft Modified One-Stage Procedure for the Treatment of Deep Isolated Gingival Recessions in Mandibular Incisors

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Alvaro Francisco Bosco ◽  
Juliano Milanezi de Almeida ◽  
Belén Retamal-Valdes ◽  
Renata Tavares ◽  
Jessica M. Latimer ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Donor Site ◽  
Root Coverage ◽  
Connective Tissue Graft ◽  
One Stage ◽  
Tissue Graft ◽  
Adjacent Tooth ◽  
Keratinized Tissue ◽  
Subepithelial Connective Tissue Graft ◽  
Mandibular Incisors

The laterally positioned flap (LPF) has been proposed as a promising treatment for isolated gingival recessions (GRs) in mandibular incisors. Several modifications have been proposed to reduce the risk of gingival recession (GR) at the donor tooth site. Therefore, the aim of this was to describe a modified one-stage procedure of performing the LPF associated with the subepithelial connective tissue graft (LPF + SCTG) with the modifications for the treatment of deep isolated GR in mandibular incisors. The modified one-stage technique (LPF + SCTG) is unique because it was presented being bilaminar with tunneled connective tissue graft (CTG) in the adjacent tooth and extended to the flap donor site, without a submarginal incision in the adjacent tooth, taking the entire band of the keratinized tissue (KT) into the flap. In addition, 3 clinical cases were described using this surgical technique. Three healthy patients with Cairo RT1 or RT2 GRs on teeth 31 or 41 were treated with the LPF + SCTG technique. Probing depth (PD), clinical attachment level (CAL), complete root coverage (CRC), mean root coverage (MRC), recession depth (RD), and keratinized tissue width (KTW) were assessed at baseline and in the follow-up periods of 18, 24, and 48 months, in the cases 1, 2, and 3, respectively. The LPF + SCTG with the modifications presented is a predictable approach for the treatment of deep isolated RT1 and RT2 GRs in mandibular incisors that are well positioned in the bone envelope with the presence of KTW adjacent to GR and adequate vestibule depth in the donor area of the flap.

Pseudoaneurysm of the Greater Palatine Vessel Following Subepithelial Connective Tissue Graft

2019 ◽  
Vol 45 (6) ◽  
pp. 483-485
Author(s):  
Joshua Segal ◽  
Monika Patel ◽  
Henry Woo ◽  
Rachel Pruitt
Keyword(s):  
Connective Tissue ◽  
Donor Site ◽  
Flap Necrosis ◽  
Root Coverage ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Graft Harvest ◽  
Subepithelial Connective Tissue Graft ◽  
Tissue Grafts

Subepithelial gingival connective tissue grafts are a common surgical procedure performed in periodontal and implant surgery. This versatile procedure has many indications including tooth root coverage, thickening of gingiva, and improvement of the quality of the crestal gingiva. Several techniques have been described for graft harvest from the palate. Reported complications from these techniques include pain, inflammation, bleeding, flap necrosis, and infection in the donor site. We report a previously unpublished complication following subepithelial gingival connective tissue graft from the palate: pseudoaneurysm of the greater palatine vessel.

scholarly journals Effect of 24% EDTA root conditioning on the outcome of modified coronally advanced tunnel technique with subepithelial connective tissue graft for the treatment of multiple gingival recessions: a randomized clinical trial

2021 ◽  
Author(s):  
Bartłomiej Górski ◽  
Marcin Szerszeń ◽  
Tomasz Kaczyński
Keyword(s):  
Connective Tissue ◽  
Ethylenediaminetetraacetic Acid ◽  
Treatment Modalities ◽  
Root Coverage ◽  
Gingival Thickness ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Keratinized Tissue ◽  
Patient Reported ◽  
Subepithelial Connective Tissue Graft

Abstract Objectives To investigate effects of root conditioning with 24% ethylenediaminetetraacetic acid (EDTA) on the 12-month outcomes after treatment of multiple gingival recessions (GR) with modified coronally advanced tunnel (MCAT) and subepithelial connective tissue graft (SCTG). Materials and methods Twenty patients with 142 GR were treated (72 test sites: SCTG + EDTA and 70 control sites: SCTG). Average and complete root coverage (ARC, CRC), gain in keratinized tissue width (KTW), gain in gingival thickness (GT), root esthetic coverage score (RES), and patient-reported outcome measures (PROMs) were evaluated at 12 months post-operatively. Results Differences between pre- and post-operative values were statistically significant only within but not between treatment modalities. At 12 months, ARC was 86.0% for SCTG + EDTA-treated and 84.6 for SCTG-treated defects (p = 0.6636). CRC was observed in 90.2% (tests) and 91.4% (controls) of all cases (p = 0.9903). Professional assessment of esthetic outcomes using RES showed highly positive results reaching the value of 8.9 in case of test sites and 8.7 for control sites (p = 0.3358). Severity of pain and swelling did not differ between sites, regardless of whether EDTA was used. Conclusions Test and control sites presented similarly positive outcomes related to root coverage, periodontal and esthetic parameters, and patient satisfaction and self-reported morbidity with no statistical differences between them 12 months after surgery. No significant differences in evaluated variables were observed between sites treated with and without 24% EDTA. Clinical relevance Considering the limitations of the present study, the use of 24% EDTA for root conditioning did not improve 12-month outcomes after treatment of multiple RT1 and RT2 gingival recessions with MCAT and SCTG. Trial registration ClinicalTrials.gov identifier: NCT03354104

scholarly journals EFFECT OF SMOKING ON THE PERIODONTAL MICROSURGERY TECHNIQUE ON THE TREATMENT OF GINGIVAL RECESSION

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Renata De Araújo Barbosa ◽  
Mônica Dourado ◽  
Maria Cecília Azoubel ◽  
Roberta Santos Tunes ◽  
Érica Del Peloso Ribeiro ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Gingival Recession ◽  
Root Coverage ◽  
Average Percentage ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Keratinized Tissue ◽  
Probing Depth ◽  
Subepithelial Connective Tissue Graft ◽  
Attachment Level

This paper aims to evaluate the effects of smoking on periodontal microsurgery technique using the subepithelial connective tissue graft (SCTG) for treatment of gingival recession on smokers. 14 patients nonsmokers and 12 smokers were selected, presenting Miller’s Class I and II gingival recession ≥ 2.0 mm. For both groups, the subepithelial connective tissue graft was used with the aid of a surgical microscope. The clinical parameters of width and height of the gingival recession, height and thickness of keratinized tissue, probing depth and clinical attachment level were evaluated before and six months after surgery. At the end of the study, there were obtained an average percentage of 96.66% of root coverage on nonsmokers and 82.49% on smokers (p=0.03). Complete root coverage was observed in 78,57% and 50% of patients, respectively. Therapy can benefit both groups, but smokers have less favorable outcomes to root coverage with periodontal microsurgery using the SCTG.

Subepithelial Connective Tissue Graft for Gingival Recession Coverage: A Case Report

2020 ◽  
Author(s):  
Anita Mehta
Keyword(s):  
Case Report ◽  
Connective Tissue ◽  
Gingival Recession ◽  
Tooth Brushing ◽  
Vulnerable Area ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Keratinized Tissue ◽  
Subepithelial Connective Tissue Graft ◽  
Dentinal Hypersensitivity

The Gingival recession is considered a multi-factorial. The etiology may be an anatomically vulnerable area, faulty tooth brushing, high frenum attachment. In cases where there is progressive recession, aesthetics concern or increasing dentinal hypersensitivity, we can do recession coverage. Depending upon the presence or absence of adequate keratinized tissue we can choose the technique. In case of adequate width of keratinized tissue, usually we can do displaced flap and in case where there is inadequate width, we can do gingival grafting.

scholarly journals ROOT COVERAGE USING THE SUBEPITHELIAL CONNECTIVE TISSUE GRAFT OR THE ACELLULAR DERMAL MATRIX FOR THE TREATMENT OF GINGIVAL RECESSION: A CLINICAL STUDY

2018 ◽  
Vol 9 ◽  
pp. 20
Author(s):  
Shula Zuleika Sumana ◽  
Sri Lelyati C Masulili ◽  
Robert Lessang
Keyword(s):  
Connective Tissue ◽  
Acellular Dermal Matrix ◽  
Gingival Recession ◽  
Root Coverage ◽  
Dermal Matrix ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Operative Data ◽  
Subepithelial Connective Tissue Graft ◽  
Acellular Dermal

Objective: This study aims to evaluate periodontal clinical conditions after treatment for gingival recession (GR) using subepithelial connective tissue graft (SCTG) and acellular dermal matrix (ADM).Methods: Ten patients with Miller’s Class I and II recessions that had been treated with SCTG or ADM at the Periodontics Outpatient Department at Universitas Indonesia were selected for this study. The pre-operative data for GR, clinical attachment levels (CAL), and attached gingiva (AG) were retrieved from the patients’ medical records. The patients were recalled and the post-operative data were recorded.Results: The application of SCTG and ADM yields significant changes to GR, CAL, and AG levels. A comparison of two groups at the post-operative assessment stage showed no statistically significant differences, in terms of GR, CAL, and AG.Conclusion: SCTG and ADM yield similar outcomes in the treatment of GR. As such, ADM may be suggested as an alternative to SCTG for root coverage.

scholarly journals Palatal Harvesting Technique Modification for Better Control of the Connective Tissue Graft Dimensions

2013 ◽  
Vol 24 (6) ◽  
pp. 565-568 ◽  
Author(s):  
Danilo Maeda Reino ◽  
Arthur Belem Novaes Jr. ◽  
Marcio Fernando de Moraes Grisi ◽  
Luciana Prado Maia ◽  
Sergio Luis Scombatti de Souza
Keyword(s):  
Connective Tissue ◽  
Donor Site ◽  
Case Series ◽  
Gingival Recession ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Partial Thickness ◽  
Harvesting Technique ◽  
Subepithelial Connective Tissue Graft ◽  
Graft Thickness

Subepithelial connective tissue graft (SCTG) has been extensively used for a variety of clinical applications. However, the surgical procedure may not allow control of graft thickness. The purpose of this case series is to illustrate a modification to the single incision palatal harvesting technique in order to control the SCTG thickness without increasing patient discomfort. Fifty cases from thirty systemically and periodontally healthy patients with at least one multiple gingival recession were treated with coronally advanced flaps combined with a SCTG. The palatal area served as the donor site, from where a single perpendicular incision was made to obtain a full thickness flap. Next, 1-2 mm of the flap was elevated and dissected to obtain a partial thickness flap. The graft remained attached to the full-partial thickness flap. After determining the desired SCTG thickness, the graft was harvested from the palatal flap. The patients healed uneventfully at 7 days postoperatively and primary closure was obtained for all palatal donor sites. The SCTG length and width varied depending on the needs of each case, but the SCTG thickness was well controlled with only 0.24 mm standard deviation. The suggested modification granted control of the SCTG dimensions and achieved complete wound closure within a week.

scholarly journals Vestibular incisional subperiosteal tunnel access versus coronally advanced flap with connective tissue graft for root coverage of Miller’s class I and II gingival recession: A randomized clinical trial

2019 ◽  
Vol 11 (1) ◽  
pp. 12-20
Author(s):  
Saeed Sadat Mansouri ◽  
Omid Moghaddas ◽  
Narjes Torabi ◽  
Katayoun Ghafari
Keyword(s):  
Connective Tissue ◽  
Gingival Recession ◽  
Control Group ◽  
Root Coverage ◽  
Control Groups ◽  
Coronally Advanced Flap ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Subepithelial Connective Tissue Graft ◽  
And Control

Background and aims. This study aimed to compare the clinical efficacy of vestibular incisional subperiosteal tunnel access (VISTA) with subepithelial connective tissue graft versus a coronally advanced flap (CAF) with subepithelial connective tissue graft for the treatment of gingival recession defects. Materials and methods. This randomized clinical trial was performed on 24 recession defects that were bilaterally Miller’s class I or II in the maxillary canine and premolar area. One quadrant in each patient was selected randomly to receive VISTA (test group) or CAF (control group) with connective tissue graft. Clinical parameters measured at baseline and at 3- and 6- month postoperative intervals included recession width (RW), recession depth (RD), keratinized tissue width (KTW), clinical attachment level (CAL) and probing depth (PD). Results. Healing was uneventful in both the test and control groups. At the 6-month follow-up, there was a significant decrease in RD, RW and CAL and an increase in KTW in both the test and control groups. The PD remained unchanged. At 3 and 6 months, no statistically significant differences were found between VISTA and CAF for root coverage and clinical attachment gain. Mean root coverage (MRC) was 70.69% and 67.22% in the test and control group, respectively. VISTA demonstrated higher frequency of complete root coverage (CRC) compared to CAF: 50% vs. 33% (P<0.05). The mean KTW was 2.4±0.7 mm at the test and 2.7±0.8 mm at the control sites (P>0.05) Conclusion. VISTA, as a minimally invasive approach, can enhance root coverage, KTW and clinical attachment gain; therefore, it can be used as a substitute for CAF with connective tissue graft as a gold standard for root coverage.

scholarly journals Exposed root coverage for facially prominent root utilizing the combination of GTR and subepithelial connective tissue graft

1999 ◽  
Vol 20 (1) ◽  
pp. 85-91
Author(s):  
Kitetsu Shin ◽  
Kazuyuki Watanabe ◽  
Masaaki Ishizawa ◽  
Takashi Kumagai ◽  
Yukinao Kobayashi ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Root Coverage ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Subepithelial Connective Tissue Graft ◽  
Exposed Root
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