World Journal of Dentistry

Register      Login

VOLUME 8 , ISSUE 4 ( July-August, 2017 ) > List of Articles

RESEARCH ARTICLE

Root Coverage in Miller Classes I and II associated with Subepithelial Connective Tissue Graft: A comparative Clinical Trial of Two Techniques

Vitor J Spada, Patricia O Nassar, Nahana Cardoso, Khadidjia MB Caldato, Jordana H Pandini, Deisy M Randon, Carlos A Nassar

Citation Information : Spada VJ, Nassar PO, Cardoso N, Caldato KM, Pandini JH, Randon DM, Nassar CA. Root Coverage in Miller Classes I and II associated with Subepithelial Connective Tissue Graft: A comparative Clinical Trial of Two Techniques. World J Dent 2017; 8 (4):248-254.

DOI: 10.5005/jp-journals-10015-1446

Published Online: 01-08-2017

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

Introduction

Gingival recession is characterized by apical positioning of the gingival side in relation to the cementoenamel junction. Thus, this study aimed at evaluating the effectiveness of two surgical techniques for root coverage in patients with gingival recession of Miller class I or II.

Materials and methods

A total of 13 patients were selected, from the age group of 20 to 50 years, with bilateral gingival recession Miller class I or II, totaling 34 recessions. When the basic periodontal treatment was accomplished, every recession was included in one of both selected groups according to the surgical technique: Control group—Subepithelial connective tissue graft associated with coronally positioned flap technique and test group—Subepithelial connective tissue graft associated with the modified envelope technique. Patients were evaluated for 180 days, and the periodontal parameters were analyzed in 0, 90, and 180 days.

Results

The results showed that both surgeries were effective since they kept probe depths with periodontal health and clinical attachment gain (p < 0.05) in both groups, up from 90 days. The reduction was kept for 180 days, mainly for the control group that showed a clinical attachment gain that was still statistically significant at 180 days (p < 0.05). Regarding the root coverage, the control group showed a 90.2% of coverage while the test group showed 89.5%.

Conclusion

Thus, it can be concluded that both techniques, after 180 days, were effective for the health of periodontal tissues; however, a greater emphasis can be observed on the subepithelial connective tissue graft-associated coronally positioned flap technique because this technique demonstrated a greater significant gain in the clinical attachment level.

Clinical significance

The subepithelial connective tissue graft is used for gaining the clinical attachment level in the root coverage of patients with gingival recession Miller classes I and II.

How to cite this article

Spada VJ, Nassar PO, Cardoso N, Caldato KMB, Pandini JH, Randon DM, Nassar CA. Root Coverage in Miller Classes I and II associated with Subepithelial Connective Tissue Graft: A comparative Clinical Trial of Two Techniques. World J Dent 2017;8(4):248-254.


PDF Share
  1. Glossary of periodontal terms. J Periodontol 2001, 4th Edition, p. 44. (most current).
  2. Surgical treatment options for grafting areas of gingival recession association with cervical lesions: a review. J Esthet Restor Dent 2013 Dec;25(6):371-382.
  3. Periodontal plastic surgery. Periodontol 2000 2015 Jun;68(1):333-368.
  4. Coronally repositioned periodontal flap. Clinical evaluation after one year. J Clin Periodontol 1975 Feb;2(1):1-13.
  5. A surgical procedure for the treatment of localized gingival recession in conjunction with root surface citric acid conditioning. J Periodontol 1980 Sep;51(9):505-509.
  6. Treatment of gingival recession with coronally advanced flap procedures: a systematic review. J Clin Periodontol 2008 Sep;35(8 Suppl):136-162.
  7. Root coverage esthetic score: a system to evaluate the esthetic outcome of the treatment of gingival recession through evaluation of clinical cases. J Periodontol 2009 Apr;80(4):705-710.
  8. Subepithelial connective tissue graft technique for root coverage. J Periodontol 1985 Dec;56(12):715-720.
  9. Coronally advanced flap connective tissue graft techniques for the treatment of deep gingival recession in the lower incisors. A controlled randomized clinical trial. J Clin Periodontol 2014 Aug;41(8):806-813.
  10. Covering localized areas of root exposure employing the “envelope” technique. J Periodontol 1985 Jul;56(7):397-402.
  11. Use of the supraperiosteal envelope in soft tissue grafting for root coverage. I. Rationale and technique. Int J Periodontics Restorative Dent 1994 Jun;14(3):216-227.
  12. A classification of marginal tissue recession. Int J Periodontics Restorative Dent 1985;5(2):8-13.
  13. Randomized controlled trials: what are they and who needs them? Periodontol 2000 2012 Jun;59(1):14-31.
  14. Root-coverage procedures for the treatment of localized recession-type defects: a Cochrane systematic review. J Periodontol 2010 Apr;81(4):452-478.
  15. Comparing semilunar coronally positioned flap to standard coronally positioned flap using periodontal clinical parameters. Gen Dent 2014 Mar-Apr;62(2):47-49.
  16. Periodontal disease in pregnancy. II – correlation between oral hygiene and periodontol condition. Acta Odontol Scand 1964 Feb;22:121-135.
  17. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 1963 Dec;21:533-551.
  18. Reprinting the classic article on USPHS evaluation methods for measuring the clinical research performance of restorative materials. Clin Oral Investig 2005 Dec;9(4):209-214.
  19. Flap approaches in plastic periodontal and implant surgery: critical elements in design and execution. J Clin Periodontol 2014 Apr;41(Suppl 15):S108-S122.
  20. Does placement of a connective tissue graft improve the outcomes of coronally advanced flap for coverage of single gingival recessions in upper anterior teeth? A multi-centre, randomized, double-blind, clinical trial. J Clin Periodontol 2009 Jan;36(1):68-79.
  21. Clinical efficacy of periodontal plastic surgery procedures: consensus report of Group 2 of the 10th European Workshop on Periodontology. J Clin Periodontol 2014 Apr;41(Suppl 15):S36-S43.
  22. Clinical and anatomical factors limiting treatment outcomes of gingival recession: a new method to predetermine the line of root coverage. J Periodontol 2006 Apr;77(4):714-721.
  23. Interdental papilla management: a review and classification of the therapeutic approaches. Int J Periodontics Restorative Dent 2004 Jun;24(3):246-255.
  24. Subpedicle connective tissue graft versus free gingival graft in the coverage of exposed root surfaces. A 5-year clinical study. J Clin Periodontol 1997 Jan;24(1):51-56.
  25. Treatment of gingival recession: comparison of two techniques of subepithelial connective tissue graft. J Periodontol 2005 Nov;76(11):1842-1848.
  26. Coronally advanced flap: the post-surgical position of the gingival margin is an important factor for achieving complete root coverage. J Periodontol 2005 May;76(5):713-722.
  27. Connective tissue grafting employing the tunnel technique: a case report of complete root coverage in the anterior maxilla. Int J Periodontics Restorative Dent 2001 Feb;21(1):77-83.
  28. Coronally advanced flap with and without vertical releasing incisions for the treatment of multiple gingival recessions: a comparative controlled randomized clinical trial. J Periodontol 2009 Jul;80(7):1083-1094.
  29. Treatment of adjacent gingival recessions with subepithelial connective tissue grafts and the modified tunnel technique. Quintessence Int 2003 Jan;34(1):7-13.
  30. Gingival blood circulation after experimental wounds in man. J Clin Periodontol 1979 Dec;6(6):417-424.
  31. Factors affecting histology of a human biopsy section following the placement of a subepithelial connective tissue graft. Int J Periodontics Restorative Dent 2000 Jun;20(3):225-231.
  32. Histology of a human biopsy section following the placement of a subepithelial connective tissue graft. Int J Periodontics Restorative Dent 2000 Jun;20(3):225-231.
  33. Histology of connective tissue graft. A case report. J Periodontol 2001 Nov;72(11):1607-1615.
  34. Evaluation of human recession defects treated with coronally advanced flaps and either enamel matrix derivative or connective tissue. Part 2: Histological evaluation. J Periodontol 2003 Aug;74(8):1126-1135.
  35. Root surface biomodification with EDTA for the treatment of gingival recession with a semilunar coronally repositioned flap. J Periodontol 2007 Sep;78(9):1695-1701.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.