Microsurgical treatment of gingival recession: a controlled clinical study (original) (raw)
Related papers
Fifteen-Year Follow-Up of a Case of Surgical Retreatment of a Single Gingival Recession
Case Reports in Dentistry, 2018
Purpose. e aim of the present case report was to describe the retreatment of the single gingival recession in aesthetic area, in the presence of scar formation and consequent impairment of aesthetic appearance. Methods. A young patient with one single recession of 4 mm of 2.1 was treated with coronally advanced flap and subepithelial connective tissue graft, through a microsurgical approach that aimed at the removal of the scarred fibrous tissue. e intervention was performed using a surgical microscope as a magnification device. Results. Fifteen years after the surgical treatment, a substantial stable resolution of the gingival recession could be observed. Moreover, a further improvement of the aesthetic appearance could be observed. Conclusions. is case report suggests that periodontal microsurgery could be an effective approach for the retreatment of gingival recessions and, in long-term evaluation, to reduce the aesthetic problem due to the presence of scar formation. Further studies with a larger sample size are needed to better evaluate its efficacy.
Coverage of localized gingival recessions: comparison of micro- and macrosurgical techniques
Journal of Clinical Periodontology, 2005
Background: In the presence of a thin and narrow zone of gingival tissue root recessions caused by trauma or inflammatory reactions seem to be a common feature of the buccal tissue morphology. The surgical coverage is mainly indicated for aesthetic reasons and may be accomplished with pedicled flaps in conjunction with or without the use of connective tissue grafts. Aim: The purpose of the present study was to evaluate the degree of vascularization of connective tissue grafts by applying a microsurgical approach. In addition, the clinical outcome was followed for 1 year. Material and Methods: The study population consisted of 10 patients with bilateral Class I and II recessions at maxillary canines. In split-mouth design, the defects were randomly selected for recession coverage either by a microsurgical (test) or macrosurgical (control) approach. Immediately after the surgical procedures, and after 3 and 7 days of healing, fluorescent angiograms were performed to evaluate graft vascularization. In addition, the clinical parameters were assessed before the surgical intervention, and 1, 3, 6 and 12 months postoperatively. Results: The results of the angiographic evaluation at test sites revealed a vascularization of 8.9 AE 1.9% immediately after the procedure. After 3 days and after 7 days, the vascularization rose to 53.3 AE 10.5% and 84.8 AE 13.5%, respectively. The corresponding vascularization at control sites were 7.95 AE 1.8%/44.5 AE 5.7% and 64.0 AE 12.3%, respectively. All the differences between test and control sites were statistically significant. The clinical measurements revealed a mean recession coverage of 99.4 AE 1.7% for the test and 90.8 AE 12.1% for the control sites after the first month of healing. Again, this difference was statistically significant. The percentage of root coverage both test and control sites remained stable during the first year at 98% and 90%, respectively. Conclusions: The present controlled clinical study has demonstrated that in root surface coverage, a microsurgical approach substantially improved the vascularization of the grafts and the percentages of root coverage compared with applying a conventional macroscopic approach.
A New Method for Volumetric Evaluation of Gingival Recessions: A Feasibility Study
Journal of Periodontology, 2012
Background: This preliminary in vitro study, presented at the General Session of the International and American Association for Dental Research in 2010 (Barcelona, Spain), evaluates whether three-dimensional (3D) optical scanning and subsequent superimposing procedures could be used for reproducible volumetric evaluation of gingival recession.
IP International Journal of Periodontology and Implantology, 2021
Gingival anatomic factors, chronic trauma, periodontitis, and tooth alignment are the main conditions leading to gingival recession. The present study was conducted to compare the root coverage of localized GR using modified coronally advanced flap (CAF) and root conditioning with 24% EDTA when performed under magnification and without magnification. This study was conducted on 30 patients with Miller’s Class I and II GR. Patients were divided into 2 groups i.e 15 in each group. Group I (Coronally advanced flap with microsurgery ) was test group and group II (Coronally advanced flap with macrosurgical approach) was control. Plaque index (PI), gingival index (GI), pocket probing depth (PD), and clinical attachment level (CAL) width of keratinized gingival, recession width and recession depth was recorded in both groups at baseline 1and 3 months for the test and control group. Visual analog scale (VAS) was used to record pain postoperatively on 3rd and 7th day of the surgery. CAF and ...
Microsurgical Approach To Subepithelial Connective Tissue Graft For Treatment of Gingival Recession
Journal of Contemporary Dentistry, 2011
Gingival recession is one of the most common mucogingival deformity and treatment should be rendered in a manner such that the best esthetic results are achieved. Periodontal plastic surgery is a rapidly emerging field, which helps us to meet this criterion. Various techniques have been employed in the past years using conventional surgical procedures to achieve coverage of denuded roots. Increased patient awareness has generated the demand for an ideal therapy encompassing the elimination of disease and the restoration of esthetics and function that is administered with minimal trauma and discomfort.. This case report throws light on the use of a surgical operating microscope to cover Miller's class I gingival recession in a maxillary left canine using the subepithelial connective tissue graft technique and its advantages over the conventional technique under normal or macro vision. Satisfactory root coverage was obtained with excellent esthetics and patient comfort.
World journal of dentistry, 2024
Aim: To assess scalpel and laser techniques of depigmentation by clinical parameters and digital photographic analysis. Materials and methods: In this split-mouth clinical study, 64 sites with gingival hyperpigmentation were selected. Group I was scalpel and group II was diode laser. Clinical parameters, that is, the Dummett oral pigmentation index (DOPI) and the Hedin melanin index (HMI) were recorded. Standardized digital photographs of pigmented areas were taken, and red, green, and blue (RGB) image statistics were done using Adobe Photoshop software. The patient's perception of pain was recorded on the visual analog scale (VAS) scale, and the repigmentation and time of the competition of the procedure were assessed. The timeline of the study was baseline, 3, and 6 months. Statistical analysis was done using the paired t-test and the student t-test. Results: Dummet oral pigmentation index (DOPI) and HMI showed highly statistically significant differences during the timelines, but no significant difference was between the groups. The digital analysis by RGB method showed statistically significant and clinically significant results in melanin reduction preoperatively and postoperatively. Comparative pain assessment and duration of the procedure were highly significant in laser compared to a scalpel. The repigmentation rate showed a high recurrence rate in the laser group. Conclusion: The RGB values suggest effectiveness in evaluating differences in hue on surgical techniques for hyperpigmentation of gingiva. The rate of repigmentation is less in the scalpel technique. Both surgical and diode lasers were efficient for depigmentation of the gingiva and did not result in any postoperative complications. Clinical significance: The scalpel and laser technique showed significant results so it can be used efficiently to restore the pink esthetic. Laser therapy in terms of pain perception and duration is better. The digital photographic analysis method (RGB values) and clinical evaluation (indices) can be used to assess the patient preoperatively and postoperatively.
Minimally invasive approach to the gingival recession
Journal of Indian Society of Periodontology, 2013
Some aspects of pathogenesis and therapeutic approach to the gingival recession are discussed in this short communication with the example of a typical case from Russia, where excessive socket curettage after a tooth extraction resulted in a marked gingival recession. Subgingival plaque and calculus can be secondary to recession. An argument about plaque as a source of microorganisms might be plausible in case of inflammation, although various microorganisms are normal for the oral cavity. From the viewpoint of general pathology, being an atrophic condition, recession can progress due to repeated damage. On the author's opinion, calculus removal is not indicated at least for aged patients with marked gingival recession, having modest esthetic demands. Socket curettage after exodontia should be gentle. Surgical treatment of the gingival recession is beyond the scope of this communication.