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Yang Q, Fan Z, Tang P, Jiang Y, Han M, Li L. Characteristics of mandibular anterior alveolar bone in patients with different degrees of periodontitis: a retrospective study based on CBCT. Clin Oral Investig 2023; 27:6709-6721. [PMID: 37777638 DOI: 10.1007/s00784-023-05280-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/24/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVES To investigate the alveolar bone characteristics of mandibular anterior teeth in patients with periodontitis. MATERIALS AND METHODS 100 patients with periodontitis were selected and grouped according to the degrees of alveolar bone resorption, age, gender, and tooth type. The labial thickness of the alveolar bone, the degree of alveolar bone resorption, angulation between the long axis of teeth and alveolar process, alveolar bone height and density of the mandibular anterior teeth were measured. RESULTS There were significant differences in alveolar bone morphology between these three groups. Compared with the mild and moderate groups, the severe group showed that the alveolar bone in the half of the root crown was thickened, the alveolar bone height was decreased, the cancellous alveolar bone density was increased, and the cortical alveolar bone density was decreased. The resorption of alveolar bone was characterized by greater resorption of proximal bone than that of labial bone with increased bone loss. There were also differences in alveolar bone characteristics among patients of different ages, genders, and tooth types. CONCLUSIONS The morphology of the mandibular anterior alveolar bone changed accordingly with the degree of periodontitis. Labial alveolar bone thickness and cortical alveolar bone density were negatively correlated with the degree of periodontitis, while alveolar bone height and cancellous alveolar bone density were positively correlated with the degree of periodontitis. CLINICAL RELEVANCE These results allow clinicians to better understand the alveolar bone morphology of the mandibular anterior teeth in patients with periodontitis, facilitating better treatment design and avoiding complications.
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Affiliation(s)
- Qi Yang
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Zixin Fan
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Pengzhou Tang
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Yue Jiang
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Minxuan Han
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China.
- Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
| | - Lu Li
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China.
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Singh M, Renuka R, Nagi PK, K I AMM, Lakshmi YC. Modified Free Gingival Autograft: A Case Report. Cureus 2023; 15:e45920. [PMID: 37885538 PMCID: PMC10599267 DOI: 10.7759/cureus.45920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2023] [Indexed: 10/28/2023] Open
Abstract
The purpose of this case study was to introduce an innovative method utilizing a modified free gingival graft technique, with the goal of accomplishing vertical and horizontal augmentation of soft tissue in the mandibular anterior region. A 35-year-old female patient underwent the modified free gingival graft technique in the anterior mandibular area. Remarkably, after a span of nine months, an increase was noted in both horizontal and vertical dimensions of the gingival tissue. This transformation was met with satisfaction from the patient. Following the successful graft procedure, a vertical gain of 3 mm was observed in the keratinized gingiva.
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Affiliation(s)
- Manpreet Singh
- Periodontics, Punjab Government Dental College and Hospital, Amritsar, IND
| | - Renuka Renuka
- Prosthodontics, Himachal Institute of Dental Sciences, Paonta Sahib, IND
| | - Puneet Kamal Nagi
- Periodontics, Punjab Government Dental College and Hospital, Amritsar, IND
| | - Azhagu Mani Malar K I
- Oral Pathology and Microbiology, Vivekanandha Dental College for Women, Elaiyampalayam, IND
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Schincaglia GP, Agusto M, Thacker S, Thomas Simpson K, Salman A. Gingival pedicle with split-thickness tunnel technique: A retrospective case series for single mandibular anterior recessions. Clin Adv Periodontics 2023; 13:137-143. [PMID: 35412668 DOI: 10.1002/cap.10197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 02/24/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Gingival recessions in the mandibular anterior sextant are a common clinical finding, but mucogingival treatment in this location is particularly challenging, due to several anatomical and surgical difficulties. In the present case series, a novel technique, called gingival pedicle with split-thickness tunnel (GPST), was retrospectively evaluated. CASE SERIES Fifteen patients presenting with a single buccal RT1 or RT2 gingival recession of a depth of ≥3 mm in the mandibular anterior sextant were treated by means of the GPST technique. Clinical periodontal parameters at baseline and at the last follow-up evaluation visit (6-84 months) were compared. Early healing was uneventful in all cases, and no complications such as flap dehiscence or loss of connective tissue graft were observed. Mean root coverage (mRC) was 98.1% ± 7.38%, corresponding to a statistically significant recession reduction (ΔRD) of 4.53 ± 1.19 mm. Complete root coverage was achieved in 14 of 15 cases. The gain in keratinized tissue width amounted to 3.13 ± 0.99 mm and was statistically significant, whereas no significant change in periodontal probing depth was observed after treatment. CONCLUSION In conclusion, treatment with GPST technique seems to achieve a favorable and predictable clinical improvement in gingival recessions on mandibular anterior teeth. Why are these cases new information? Limited information is available about the management of isolated deep labial recessions in the mandibular anterior teeth. A novel surgical approach, called GPST technique, is described in a case series to specifically address this type of defect. What are the keys to successful management of these cases? Horizontal incision ≥ RECwidth Cut-back preparation helps to mobilize the flap without tension. CTG width ≥ 3 times RECwidth CTG height ≥ RECdepth Proper graft and flap stabilization need to be achieved. What are the primary limitations to success in these cases? Limited mesio-distal dimensions, which do not allow to obtain a pedicle with adequate horizontal width Very thin biotype may not be suitable because of the risk of inadequate flap vascularization.
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Affiliation(s)
- Gian Pietro Schincaglia
- Department of Periodontics, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA
- Department of Periodontics, School of Dentistry, West Virginia University, Morgantown, West Virginia, USA
| | - Michele Agusto
- Department of Periodontics, School of Dentistry, West Virginia University, Morgantown, West Virginia, USA
| | - Sejal Thacker
- Division of Periodontics, University of Connecticut School of Dental Medicine, Farmington, Connecticut, USA
| | - Kerri Thomas Simpson
- Department of Periodontics, School of Dentistry, West Virginia University, Morgantown, West Virginia, USA
| | - Arif Salman
- Department of Periodontics, School of Dentistry, West Virginia University, Morgantown, West Virginia, USA
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Naser MY, Momani M, Naser AY, Alarabeyat MA, Altarawneh AMB, Aladwan AS. Oral health profile and periodontal diseases awareness and knowledge among the jordanian population: a cross-sectional study. BMC Oral Health 2023; 23:503. [PMID: 37468879 DOI: 10.1186/s12903-023-03203-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/05/2023] [Indexed: 07/21/2023] Open
Abstract
OBJECTIVE To explore the oral health profile and periodontal diseases awareness and knowledge among the Jordanian population. In addition, we aimed to identify predictors of good knowledge of periodontal diseases. METHOD This was an online cross-sectional survey study that was conducted in Jordan between January and May 2022. A total of 13 item from the world health organisation (WHO) oral health questionnaire for adults were used to examine the oral health profile of our study participants. In addition, a previously developed questionnaire by Abdulbaqi et al. were adapted and used to examine participants' knowledge about periodontal diseases. Binary logistic regression analysis was used to identify predictors of better knowledge of periodontal diseases. RESULTS This study involved 1,099 participants in total. More than half of them (61.1%) claimed that throughout the previous 12 months, they had experienced pain or discomfort in their mouths or teeth. Nearly half of the participants said their teeth and gums were in good or very good condition. 70.7% said they brush their teeth once or more per day. The vast majority of them (93.0%) claimed to brush their teeth using toothpaste that contained 61.9% fluoride. The most frequent cited cause for dental visits was pain or difficulty with teeth, gums, or mouth (36.3%), according to almost one-third of study participants who said they had visited a dentist during the previous six months. The most commonly reported problems that occurs frequently due to the state of the participants' teeth or mouth were avoiding smiling because of teeth, feeling embarrassed due to appearance of teeth, and having difficulty in biting foods with 11.0%, 10.2%, and 9.0%, respectively. Tea with sugar (16.5%) was the most frequently reported beverage as being consumed frequently on a daily basis. The most popular tobacco product to be smoked often on a daily basis was cigarettes (21.6%). For periodontitis knowledge questions, the percentage of accurate responses ranged from 32.3 to 55.8%. The majority of participants (55.8%) were able to recognize that poor oral hygiene is one of the most frequent causes of malodor, whereas the least number of participants (32.3%) were able to recognize that improper teeth brushing is a frequent cause of gingival recession. CONCLUSION The average degree of periodontitis knowledge among Jordanians was moderate. Along with it, there were modest oral hygiene practices. In order to prevent further oral complications that have a detrimental influence on patients' quality of life, educational campaigns are required to increase public awareness of knowledge and practices in terms of proper oral hygiene and periodontitis.
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Affiliation(s)
| | - Moath Momani
- Prosthodontics Department, Royal Medical Services, Amman, Jordan
| | - Abdallah Y Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan.
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Montevecchi M, Desimini FP, Sforza N, Bagattoni S, Piana G. Role of dental training and distance of the observer on the perception of apically shifted gingival margin with increased vertical tooth size in the esthetic zone. Clin Exp Dent Res 2023; 9:171-176. [PMID: 36415147 PMCID: PMC9932252 DOI: 10.1002/cre2.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/21/2022] [Accepted: 11/05/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To evaluate the influence of the gingival contour on the smile esthetics. The influence of size, symmetry, teeth involved in apically shifted gingival margins, and the distance and clinical training of the observer were investigated. MATERIALS AND METHODS Two groups were identified: 33 first-year dental students (inexperienced) and 40 last-year students (trained). Each observer expressed four evaluations on four different images assigning a score from 0 to 10. Using a picture of an "ideal" female smile, 10 variants were virtually created by shifting (2 and 4 mm) the gingival contour apically at different sites of the upper incisors and canines. A total of 292 evaluations were collected. RESULTS Considering a score >6 for a "pleasant smile," only one 4 mm single alteration at the canine gingival contour obtained an insufficient score. "Observational distance" and "clinical training" did not influence the final score, while size and symmetry of alterations displayed a significant role. CONCLUSIONS The dental training of the observer and a close interpersonal distance seemed to be irrelevant in the esthetic perception of gingival margin alterations.
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Affiliation(s)
- Marco Montevecchi
- Dental Clinic, Department of Biomedical and Neuromotor SciencesAlma Mater Studiorum—University of BolognaBolognaItaly
| | | | - Nicola Sforza
- Private PracticeCOS Centro Odontoiatrico SforzaBolognaItaly
| | - Simone Bagattoni
- Dental Clinic, Department of Biomedical and Neuromotor SciencesAlma Mater Studiorum—University of BolognaBolognaItaly
| | - Gabriela Piana
- Dental Clinic, Department of Biomedical and Neuromotor SciencesAlma Mater Studiorum—University of BolognaBolognaItaly
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Carcuac O, Trullenque-Eriksson A, Derks J. Modified-free gingival graft technique for treatment of gingival recession defects at mandibular incisors: A randomized clinical trial. J Periodontol 2023. [PMID: 36627509 DOI: 10.1002/jper.22-0581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/12/2023]
Abstract
BACKGROUND The aim of this study was to evaluate clinical and patient-reported outcomes following surgical root coverage at RT1 gingival recession defects at mandibular incisors, using either a conventional free gingival graft (FGG) or a modified FGG (ModFGG). METHODS Total of 30 patients with RT1 gingival recessions at mandibular incisors were enrolled and randomly allocated to either a control (FGG) or test group (ModFGG). Evaluations of clinical changes (recession depth, height of keratinized tissue) and patient satisfaction were performed over a follow-up period of 12 months. Post-surgical changes of keratinized tissue height (shrinkage) were assessed from 1 month and onward. RESULTS ModFGG resulted in more pronounced root coverage at 1 year compared to FGG (91.8% vs. 60.7%, p < 0.001). Height of keratinized tissue was improved by 4.2 and 2.2 mm (p < 0.001), respectively, with significantly less shrinkage in ModFGG. Post-surgical morbidity was significantly lower for ModFGG at 2 weeks and patient satisfaction was significantly higher 12 months after treatment (9.1 vs. 5.4; p < 0.001). CONCLUSIONS ModFGG represents a valid approach for the management of RT1 recession defects at mandibular incisors. The technique is superior to traditional FGG in terms of root coverage, the gain of keratinized tissue height, and patient satisfaction.
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Affiliation(s)
- Olivier Carcuac
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,ConfiDent Dental Surgery Clinic, Palm Jumeirah, Dubai, United Arab Emirates
| | - Anna Trullenque-Eriksson
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Mayta-Tovalino F, Barboza JJ, Pasupuleti V, Hernandez AV. Efficacy of Tunnel Technique (TUN) versus Coronally Advanced Flap (CAF) in the Management of Multiple Gingival Recession Defects: A Meta-Analysis. Int J Dent 2023; 2023:8671484. [PMID: 37063452 PMCID: PMC10101741 DOI: 10.1155/2023/8671484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/06/2022] [Accepted: 03/22/2023] [Indexed: 04/18/2023] Open
Abstract
Objective We systematically assessed the efficacy of tunnel technique (TUN) vs. coronally advanced flap (CAF) in the management of multiple gingival recession defects in adults. Methods Five databases were searched until September 2021 for randomized controlled trials (RCTs) assessing TUN vs. CAF; grafts of interest were acellular dermal matrix (ADM) and connective tissue graft (CTG). Primary outcomes were root coverage (RC) and complete root coverage (CRC). Secondary outcomes were clinical attachment level (CAL), keratinized tissue width (KTW), probing depth (PD), and recession coverage (REC). Effect measures were risk ratio (RR) or mean difference (MD) with their confidence intervals (95% CI). Inverse variance methods and random-effects model meta-analyses were used. Subgroup analyses by the type of graft were performed. Quality of evidence was assessed using GRADE methodology. Results Five RCTs (n = 173) were included, with a follow-up of 6 months for all outcomes. In comparison to CAF, TUN did not significantly reduce CRC (RR 0.65; 95% CI 0.002-176.7; p = 0.51) and did not increase RC (MD 0.99%; 95% CI -6.7 to 8.6; p = 0.80). In comparison to CAF, TUN showed no significant reduction of secondary outcomes. Subgroup analyses by type of graft showed no differences in comparison to primary analyses for primary and secondary outcomes. Three RCTs had a high risk of bias, and five RCTs had very low quality of evidence for all outcomes. Conclusions In adults with gingival recessions, TUN had similar primary and secondary outcomes in comparison with CAF. Subgroup analyses by the type of graft did not affect main conclusions. More RCTs with better design are needed to further characterize the effects of TUN vs. CAF in the treatment of multiple gingival recession defects.
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Affiliation(s)
- Frank Mayta-Tovalino
- Unidad de Revisiones Sistemáticas y Meta-Análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
| | | | | | - Adrian V. Hernandez
- Unidad de Revisiones Sistemáticas y Meta-Análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
- Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Storrs, CT, USA
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Parvini P, Trimpou G, Begic A, Cafferata EA, Petsos H, Müller KM, Schwarz F, Eickholz P, Obreja K. Esthetic and clinical outcomes after immediate placement and restoration: Comparison of two implant systems in the anterior maxilla-A cross-sectional study. Clin Implant Dent Relat Res 2022; 25:252-260. [PMID: 36575853 DOI: 10.1111/cid.13158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 12/29/2022]
Abstract
AIM To assess the esthetic and clinical performance of a novel self-tapping implant system for single-tooth restorations in the esthetic zone after immediate placement and provisionalization. MATERIALS AND METHODS This cross-sectional study included 52 patients contributing a total of 52 immediately placed and restored implants with ≥12 months after functional loading, comparing two different implant systems: Straumann® BLX (Institut Straumann AG, Basel, Switzerland; 25 patients) and Ankylos® (Dentsply Sirona, Hanau, Germany; 27 patients). As the primary outcome measure, peri-implant tissue esthetics were assessed by means of pink esthetics score (PES) rated by three independent clinicians. Moreover, as secondary outcome measures, the peri-implant tissue health was assessed by means of bleeding on probing, probing depth, and suppuration. Apart from that, the modified plaque index, keratinized mucosa width, and the presence of mucosal recessions were also assessed. When clinical signs suggested the possibility of peri-implantitis, radiographs were indicated to assess progressive bone loss. RESULTS The mean PES ratings were 12.10 ± 1.10 for Ankylos versus 11.2 ± 1.86 for BLX, both achieving good esthetic results without significant differences (p = 0.143). There were no differences among most clinical parameters (plaque, bleeding on probing, probing depth, peri-implant mucosal recession), although peri-implant mucositis was present in one-third of the cases. The inter-rater agreement on esthetics was not significant (p < 0.250). CONCLUSION Within the limitations of the present study, it was concluded that the use of either BLX or Ankylos implant systems was associated to comparable peri-implant health and good pink esthetic outcomes during immediate implantation and restoration protocols, for at least 12 months.
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Affiliation(s)
- Puria Parvini
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
| | - Georgia Trimpou
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
| | - Amira Begic
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
| | - Emilio A Cafferata
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany.,Department of Periodontology, School of Dentistry, Universidad Científica del Sur, Lima, Peru
| | - Hari Petsos
- Department of Periodontology, Goethe University Frankfurt, Carolinum, Frankfurt, Germany
| | | | - Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
| | - Peter Eickholz
- Department of Periodontology, Goethe University Frankfurt, Carolinum, Frankfurt, Germany
| | - Karina Obreja
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
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Cong Z, Liu Y, Zhao J. Treatment of multiple adjacent gingival recessions with an acellular dermal matrix or a connective tissue graft: a Meta-analysis. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2022; 40:690-697. [PMID: 36416322 PMCID: PMC9763956 DOI: 10.7518/hxkq.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 09/23/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To evaluate the effectiveness of an acellular dermal matrix or a connective tissue autograft in the treatment of multiple adjacent gingival recessions through Meta-analysis. METHODS Randomized controlled trials were screened in four electronic databases in English according to the inclusion and exclusion criteria until April 20, 2022. The main outcome indicators were keratinized gingival tissue width, recession depth, probing depth, clinical attachment level, complete root coverage, and root coverage esthetic score. RESULTS Seven randomized controlled trials were included. After 12 months, the connective tissue graft in the control group could increase the keratinized gingival tissue width [mean difference (MD)=-0.28 (-0.47, -0.08), P=0.006], reduce the gingival recession depth [MD=0.23 (0.12, 0.35), P<0.000 1], and improve the complete root coverage [risk ratio=0.80, 95% confidence interval (0.69, 0.93), P=0.003] compared with the acellular dermal matrix in the experimental group. No significant difference was found in probing depth, clinical attachment level, and root coverage esthetic score between groups. CONCLUSIONS Connective tissue grafts have advantages in increasing the keratinized gingival tissue width, reducing the gingival recession depth, and improving the complete root coverage in surgeries for treating multiple adjacent gingival recessions. Acellular dermal matrices also have some clinical value in terms of operation simplicity and similar effectiveness.
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Affiliation(s)
- Zhaoxia Cong
- Dept. of Endodontics, The First Affiliated Hospital of Xin-;jiang Medical University, Urumqi 830000, China
| | - Yuan Liu
- Dept. of Endodontics, The First Affiliated Hospital of Xin-;jiang Medical University, Urumqi 830000, China
| | - Jin Zhao
- Dept. of Endodontics, The First Affiliated Hospital of Xin-;jiang Medical University, Urumqi 830000, China
- Xinjiang Oral Medical Research Institute, Urumqi 830000, China
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Lahham C, Ta'a MA. Clinical comparison between different surgical techniques used to manage advanced gingival recession (Miller's class III & IV). Heliyon 2022; 8:e10132. [PMID: 36033300 PMCID: PMC9404267 DOI: 10.1016/j.heliyon.2022.e10132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/07/2022] [Accepted: 07/27/2022] [Indexed: 11/07/2022] Open
Abstract
Advanced gingival recession is considered a complex soft tissue problem, which is increased in severity with age, and has multiple etiological factors. Therefore, the treatment is very complicated with low predictability. However, in the last decade, many clinical trials have shown highly predictable results when managing advanced recession cases by surgical intervention. The present review shows different surgical techniques with their clinical outcomes in order to choose the most suitable technique required by the clinical condition. Although there are relatively few studies, modified tunnel technique and coronal advanced flap (CAF) showed the highest percentage of root coverage (%RC) during the first year (up to 86%). These techniques are primarily indicated to manage advanced recession in the esthetic zone. Pedicle buccal fat pad (PBFP) also had a good percentage of root coverage when used in the maxillary posterior area, as it has a high blood supply with minimal risk for infection and necrosis. Free gingival graft (FGG) can be used in the mandibular anterior area, as it creates a band of keratinized tissue that can resist recession with a fair percentage of root coverage. However, color match and graft shrinkage are the main problems of this procedure.
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Affiliation(s)
- Cezar Lahham
- Dental Science Department, Faculty of Graduate Studies, Arab American University, Palestine
| | - Mahmoud Abu Ta'a
- Dental Science Department, Faculty of Graduate Studies, Arab American University, Palestine
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Alyami B. Dental cross-bite and gingival marginal recession. A cross-sectional study. Saudi Dent J 2022; 34:458-463. [PMID: 36092514 PMCID: PMC9453535 DOI: 10.1016/j.sdentj.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 11/02/2022] Open
Abstract
Background Materials and methods Results Conclusion
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12
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Gingival Displacement in the Vertical and Horizontal Dimension under the Condition of Mild Gingivitis-A Randomized Clinical Study. J Clin Med 2022; 11:jcm11020437. [PMID: 35054131 PMCID: PMC8779044 DOI: 10.3390/jcm11020437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/02/2022] [Accepted: 01/11/2022] [Indexed: 02/08/2023] Open
Abstract
This randomized clinical study aimed at quantifying the gingival displacement performance in the vertical and horizontal directions of the 3M™ Astringent Retraction Paste (3M Oral Care, Seefeld, Germany) in comparison with the double-cord technique with aluminum chloride as an astringent. Afterward, any soft-tissue changes were assessed for 12 months. After inducing mild gingivitis, 18 probands received the intervention ‘cord’ and 22 probands received the intervention ‘paste’ at the palatal half of upper premolars prior to conventional impression making. The resulting plaster casts were digitized and analyzed for the vertical and horizontal gingival displacement, applying a newly developed computer-assisted methodology. The entire palatal half of the tooth was evaluated instead of only single sites. Under the condition of mild gingivitis, the gingival displacement performance was comparable for both techniques in the horizontal direction (width) and only somewhat better for the cord technique in the vertical direction (depth). The magnitude of displacement was in a similar range in both directions, with somewhat higher values in the vertical direction. The marginal gingiva height changes were of such low extent during the follow-up period of 12 months with only minimally higher values for the paste that they cannot be considered as clinically relevant recessions.
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Tadepalli A, Chekurthi S, Kavassery Balasubramanian S, Parthasarathy H, Ponnaiyan D. Comparative Evaluation of Clinical Efficacy of Leukocyte-Rich Platelet-Rich Fibrin with Advanced Platelet-Rich Fibrin in Management of Gingival Recession Defects: A Randomized Controlled Trial. Med Princ Pract 2022; 31:376-383. [PMID: 35728577 PMCID: PMC9485915 DOI: 10.1159/000525560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 05/29/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The aim of this research was to determine and compare the clinical efficacy of leukocyte platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF) in combination with coronally advanced flap (CAF) in the treatment of gingival recession defects. METHODS Systemically healthy subjects presenting with 30 Miller's class I or II gingival recession defects in maxillary anteriors and premolars, were treated with either CAF + L-PRF or CAF + A-PRF. Clinical parameters such as recession height (RH), width, probing pocket depth, clinical attachment level (CAL), keratinized tissue height (KTH), and width of attached gingiva (WAG) were measured at baseline, 3, and 6 months. Gingival biotype was evaluated at baseline and 6 months post-surgery. Mean root coverage percentage (MRC%) was evaluated at 3 and 6 months. RESULTS Statistically significant reduction in mean RH was observed from baseline (2.53 ± 0.74 mm, 2.63 ± 0.82 mm) to 6 months (0.87 ± 0.83 mm, 0.53 ± 0.91 mm) in CAF + L-PRF and CAF + A-PRF groups, respectively. The MRC% achieved at 6 months was 67.20 ± 32.81 in the CAF + L-PRF group and 81.66 ± 28.21 in the CAF + A-PRF group. Statistically significant gain in CAL, WAG, and KTH was observed in both therapeutic groups (p < 0.05). Intergroup analysis revealed no statistically significant differences among study parameters between groups at any time point (p > 0.05). CONCLUSION Based on the findings of this study, both L-PRF and A-PRF may be suggested as viable treatment options for the management of gingival recession in maxilla.
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The comparison of the efficacy of gingival unit graft with connective tissue graft in recession defect coverage: a randomized split-mouth clinical trial. Clin Oral Investig 2021; 26:2761-2770. [PMID: 34787718 DOI: 10.1007/s00784-021-04252-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 10/23/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Gingival unit graft (GUG) is defined as the modified form of free gingival graft. The aim of this study is to compare the clinical efficacy of GUG with connective tissue graft (SCTG) with respect to clinical periodontal parameters and patient comfort scores in gingival recessions. MATERIALS AND METHODS Sixteen patients with bilateral recession type 1 (RT1) gingival recessions participated in this randomized and split-mouth study. Thirty-two defects received surgical treatment with SCTG or GUG. The recession defect coverage, periodontal measurements, and patient-reported outcomes (intra- and post-operative patient comfort, aesthetic satisfaction, and hypersensitivity) were evaluated at baseline and post-operative months 1, 3 and 6. RESULTS The favorable results were obtained in both study groups in gingival recession depth (RD), gingival recession width (RW), clinical attachment level (CAL), and keratinized tissue width (KTW). The average percentages of the recession defect coverage (RC) for GUG and SCTG group treatments after 6 months were 68.2 ± 33% and 76.4 ± 30.2%, respectively (p > 0.05). Although there was no significant difference between groups at post-operative 6 months (p > 0.05) in terms of RD, RW, CAL, RC, patient comfort, aesthetic satisfaction, and hypersensitivity parameters, the increase in KTW was significantly higher in GUG group (p < 0.05). CONCLUSIONS It was concluded that although both techniques were effective, GUG can be a convenient method for treatment of RT1 gingival recessions with inadequate KTW and (or) shallow vestibule depth. CLINICAL RELEVANCE According to the results of this study, GUG may be a preferred choice in localized gingival recessions with a lack of keratinized tissue. The trial registration number: NCT04637451.
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Fragkioudakis I, Tassou D, Sideri M, Vouros I. Prevalance and clinical characteristics of gingival recession in Greek young adults: A cross-sectional study. Clin Exp Dent Res 2021; 7:672-678. [PMID: 33939311 PMCID: PMC8543455 DOI: 10.1002/cre2.427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/27/2021] [Accepted: 03/02/2021] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE The current cross-sectional study aimed to investigate the prevalence of gingival recession (REC) in a sample of young individuals. In addition, the association with several risk factors was examined. MATERIALS & METHODS A 104 subjects, aged 18-30 years old, were randomly enrolled in the study. Participants were requested to fill in a simple structured questionnaire in order to provide information on dental hygiene habits, educational level, smoking and history of orthodontic treatment. Afterwards, all the included individuals were subjected to a thorough clinical periodontal examination including gingival recession (REC), gingival biotype, plaque levels and gingival bleeding index (GBI) assessment. RESULTS The mean prevalence of REC in the studied population surpassed 50% with an equal distribution among females and males. The most common teeth associated with REC were the lower left canine and left 1st premolar. Among the examined variables, only the bleeding index was found to be associated with the presence of REC. CONCLUSIONS Gingival recession was a prevalent condition among young individuals. Gingival inflammation was found to be the most significant factor affecting the incidence of REC.
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Affiliation(s)
- Ioannis Fragkioudakis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitra Tassou
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Sideri
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Vouros
- Department of Preventive Dentistry, Periodontology and Implant Biology, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Agusto M, Salman A, Parker D, Choi D, Schincaglia GP. Root Coverage Predictability in the Treatment of Gingival Recessions on Mandibular Anterior Teeth. JDR Clin Trans Res 2021; 7:224-233. [PMID: 33899565 DOI: 10.1177/23800844211009437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Mandibular anterior teeth are most frequently affected by gingival recession. However, data regarding mucogingival treatment aimed at root coverage in this specific location are limited. OBJECTIVE The purpose of this study was to systematically review the scientific literature and to use the meta-analytic approach to address the following focused question: "What is the effectiveness of different surgical approaches on clinical and patient-related outcomes in the treatment of buccal gingival recessions on mandibular anterior teeth?" METHODS Studies were located by searching 3 electronic databases (Medline, Scopus, and Cochrane databases) and cross-referencing. Randomized and nonrandomized studies including at least 1 arm involving the use of pedicle flaps and/or free soft tissue grafts in the treatment of gingival recessions (recession type [RT] 1 and RT2) located on the buccal aspects of mandibular centrals, laterals and canines, were included in the analysis. Primary outcome was mean root coverage (mRC), expressed in percentage, based on a 3- to 12-mo follow-up observation. A Bayesian single-arm network meta-analysis was performed to identify a treatment hierarchy of the different surgical techniques. RESULTS Sixteen studies, with a total of 23 arms, were included in the quantitative analysis. The greatest mRC is associated with laterally positioned flap (LPF) + connective tissue graft (CTG) (91.2%) and tunnel (TUN) + CTG (89.4%), whereas LPF alone, coronally advanced flap (CAF) + CTG, and free gingival graft (FGG) showed lower mRC (79.1%, 78.9%, and 68.5% respectively). TUN + CTG provides significantly greater mRC compared to CAF+CTG. No difference among the procedures could be observed in terms of keratinized tissue width gain. CONCLUSIONS Treatment hierarchy generated by an arm-based network meta-analysis model suggested that tunnel and laterally positioned flap, both in combination with connective tissue graft, may provide the greatest mean root coverage in the treatment of mandibular anterior recessions. KNOWLEDGE TRANSFER STATEMENT The results of the present systematic review can be used by clinicians when deciding which approach to adopt when treating buccal gingival recessions on mandibular anterior teeth. In particular, procedures based on a laterally positioned flap or a tunneling technique, both in combination with connective tissue graft, seem to be the most predictable therapeutic decision.
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Affiliation(s)
- M Agusto
- Department of Periodontics, School of Dentistry, West Virginia University, Morgantown, WV, USA
| | - A Salman
- Department of Periodontics, School of Dentistry, West Virginia University, Morgantown, WV, USA
| | - D Parker
- Division of Population Health Sciences, University of Alaska Anchorage, Anchorage, AK, USA
| | - D Choi
- Department of Periodontics, School of Dentistry, West Virginia University, Morgantown, WV, USA
| | - G P Schincaglia
- Department of Periodontics, School of Dentistry, West Virginia University, Morgantown, WV, USA.,School of Dentistry, University of Ferrara, Ferrara, Italy
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Kumar S, Hirani T, Shah S, Mehta R, Bhakkand SR, Shishoo D. Treating Public Health Dilemma of Gingival Recession by the Dehydrated Amnion Allograft: A 5-Year Longitudinal Study. FRONTIERS IN ORAL HEALTH 2020; 1:540211. [PMID: 35047979 PMCID: PMC8757781 DOI: 10.3389/froh.2020.540211] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 09/16/2020] [Indexed: 11/22/2022] Open
Abstract
Aim: This study aimed to evaluate the efficacy of dehydrated amnion allograft with coronally positioned flap procedure in paired Miller's class I recession defects. Methods: A total of 51 subjects were included in the study with bilateral Miller's class I gingival recession defects. In the test group, patients were treated with an amniotic membrane (AM) with a coronally positioned flap, while in the control group, patients were treated with coronally positioned flap alone. Clinical parameters such as recession depth, recession width (RW), probing depth (PD), relative attachment level (RAL), width of keratinized gingiva (WKG), and thickness of keratinized gingiva (TKG) were recorded at baseline and after 5 years of follow-up. Result: The mean baseline recession was 2.95 ± 0.89 in the test group and 2.70 ± 0.85 in the control group, and both were statically non-significant. At the end of 6 months, all the parameters, when compared with the baseline, showed a significant improvement. Intergroup comparison showed the non-significant difference in all settings except the TKG. Conclusion: AM proved to help improve the TKG. This increase in thickness helps in the long-term maintenance of the gingival margin in Miller's class I recession defect.
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Affiliation(s)
- Santosh Kumar
- Department of Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, India
| | - Tanvi Hirani
- Department of Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, India
| | - Sujay Shah
- Department of Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, India
| | - Rupal Mehta
- Department of Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, India
| | - Susmita R Bhakkand
- Department of Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, India
| | - Deepak Shishoo
- Department of Physiology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, India
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Owczarek JE, Lion KM, Radwan‐Oczko M. The impact of stress, anxiety and depression on stomatognathic system of physiotherapy and dentistry first-year students. Brain Behav 2020; 10:e01797. [PMID: 32862554 PMCID: PMC7559601 DOI: 10.1002/brb3.1797] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/11/2020] [Accepted: 07/21/2020] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION It is well proven that psychoemotional factors play causative role in development of many civilization diseases. Psychosocial stress is effecting with development of certain oral parafunctions like teeth grinding, bruxism, or cheeks biting. Eventually, all of those parafunctional activities may cause increase of masticatory muscles tone and provoke its intensification. Literature indicates that students must cope with greater level of stressful situations than the average representative of the society. METHODS The research group comprised Ist-year physiotherapy and dentistry students from University School of Physical Education in Wroclaw and Wroclaw Medical University. The study consisted the following: psychological and health questionnaires, and stomatological examination with masseter muscles' electromyography. RESULTS In intraoral examination, symptoms of parafunctions were more frequently observed in physiotherapy students. The mean tone of masseters was higher also among physiotherapy students. The level of perceived stress was high in both groups, and the experienced borderline and incorrect results in Hospital Anxiety and Depression Scale were more frequently observed in dentistry students. The mean tone of masseter muscle was rising with the level of anxiety in physiotherapy group. Among dentistry, the tendency for rise of masseter muscle tone together with level of anxiety and depression was observed. CONCLUSIONS Physiotherapy and dentistry beginners differ between each other's by prevalence of temporomandibular disorders (TMD) and oral parafunction symptoms. The level of perceived stress is high in both groups. The level of experienced anxiety and depression is higher in dentistry group. In both study groups, there is significant growth and tendency for simultaneous rise of masseter muscle tone accordingly to stress, anxiety, and depression indicators.
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Gingival Recession in a Case of Anterior Crossbite with Angle Class I Relationship. CURRENT HEALTH SCIENCES JOURNAL 2020; 46:190-192. [PMID: 32874692 PMCID: PMC7445634 DOI: 10.12865/chsj.46.02.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 04/29/2020] [Indexed: 11/18/2022]
Abstract
Anterior crossbite is one of the most common orthodontic problems encountered during the dental eruption. Usually, the anomaly becomes evident during mixed dentition, as a result of the disharmony between the dental, skeletal and functional components of the orthognathic system. As complications, the presence of the anterior dental cross bite can lead to the thinning of the vestibular alveolar process of the lower incisors and gingival recession. Periodontal changes could recede spontaneously if orthodontic treatment is applied early, in the presence of good oral hygiene. In this case, gingival recession decreased, but not completely receded after orthodontic treatment, although the patient had a good oral hygiene.
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Moro MG, Souto MLS, Rovai ES, Cesar Neto JB, Holzhausen M, Pannuti CM. Effect of magnification on root coverage surgery. BRAZILIAN JOURNAL OF ORAL SCIENCES 2020. [DOI: 10.20396/bjos.v19i0.8658221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Root coverage surgery can be performed in patients with gingival recession to cover the exposed root aiming to control hypersensitivity and promotes better aesthetic. Optical magnification has been proposed as a refinement in this surgical technique to increase root coverage. This approach may lead to enhanced soft tissue stability, less post-operative discomfort, better predictability and esthetic appearance. Aim: This systematic review aimed to evaluate the effectiveness of magnification on root coverage surgery when compared to procedures performed without magnification. Methods: Randomized controlled trials with a follow-up of at least 6 months that compared surgeries for root coverage performed under optic magnification versus conventional (macro) root coverage surgery were screened. The primary outcome was mean root coverage (mm) (MRC) and secondary outcomes were percentage of root coverage (PRC) and complete root coverage (CRC). Results: Of 569 papers relevant to this review, seven were included. Meta-analysis showed that the use of magnification may favor greater PRC (7.38%, 95% CI 3.66-11.09). Conclusion: Magnification can increase PRC in root coverage surgeries. More randomized trials with the use of magnification may be necessary to verify if this benefit is clinically relevant, in order to justify the use of this device.
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21
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Park KM, Lee HJ, Koo KT, Ben Amara H, Leesungbok R, Noh K, Lee SC, Lee SW. Oral Soft Tissue Regeneration Using Nano Controlled System Inducing Sequential Release of Trichloroacetic Acid and Epidermal Growth Factor. Tissue Eng Regen Med 2020; 17:91-103. [PMID: 31970697 DOI: 10.1007/s13770-019-00232-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/23/2019] [Accepted: 11/28/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The effect of nano controlled sequential release of trichloroacetic acid (TCA) and epidermal growth factor (EGF) on the oral soft tissue regeneration was determined. METHODS Hydrophobically modified glycol chitosan (HGC) nano controlled system was developed for the sequential release of TCA and EGF, and the release pattern was identified. The HGC-based nano controlled release system was injected into the critical-sized defects created in beagles' palatal soft tissues. The palatal impression and its scanned body was obtained on various time points post-injection, and the volumetric amount of soft tissue regeneration was compared among the three groups: CON (natural regeneration control group), EXP1 (TCA-loaded nano controlled release system group), EXP2 (TCA and EGF individually loaded nano controlled release system). DNA microarray analysis was performed and various soft tissue regeneration parameters in histopathological specimens were measured. RESULTS TCA release was highest at Day 1 whereas EGF release was highest at Day 2 and remained high until Day 3. In the volumetric measurements of impression body scans, no significant difference in soft tissue regeneration between the three groups was shown in two-way ANOVA. However, in the one-way ANOVA at Day 14, EXP2 showed a significant increase in soft tissue regeneration compared to CON. High correlation was determined between the histopathological results of each group. DNA microarray showed up-regulation of various genes and related cell signaling pathways in EXP2 compared to CON. CONCLUSION HGC-based nano controlled release system for sequential release of TCA and EGF can promote regeneration of oral soft tissue defects.
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Affiliation(s)
- Kwang Man Park
- Department of Dentistry, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Hong Jae Lee
- Department of Maxillofacial Biomedical Engineering and Institute of Oral Biology, School of Dentistry, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Ki-Tae Koo
- Department of Periodontology and Dental Research Institute Translational Research Laboratory for Tissue Engineering (TTE), School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Heithem Ben Amara
- Department of Periodontology and Dental Research Institute Translational Research Laboratory for Tissue Engineering (TTE), School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Richard Leesungbok
- Department of Biomaterials and Prosthodontics, Kyung Hee University Hospital at Gangdong Institute of Oral Biology, School of Dentistry, Kyung Hee University, 892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea
| | - Kwantae Noh
- Department of Prosthodontics, School of Dentistry, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Sang Cheon Lee
- Department of Maxillofacial Biomedical Engineering and Institute of Oral Biology, School of Dentistry, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
| | - Suk Won Lee
- Department of Biomaterials and Prosthodontics, Kyung Hee University Hospital at Gangdong Institute of Oral Biology, School of Dentistry, Kyung Hee University, 892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea.
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Fageeh HN, Meshni AA, Jamal HA, Preethanath RS, Halboub E. The accuracy and reliability of digital measurements of gingival recession versus conventional methods. BMC Oral Health 2019; 19:154. [PMID: 31311544 PMCID: PMC6636111 DOI: 10.1186/s12903-019-0851-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 07/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An apical shift in the position of the gingiva beyond the cemento-enamel junction leads to gingival recession. This study aimed to evaluate the reproducibility of digital measurements of gingival recession when compared to conventional measurements taken clinically using periodontal probes. METHODS Gingival recession was measured at 97 sites in the oral cavity by four examiners using the following methods: CP, direct measurement of gingival recession using William's periodontal probe intraorally; CC, measurements on cast models using a caliper; DP, digital measurement on virtual models obtained by intraoral scanning, and DC, digital measurements on virtual models of dental casts. Intra-class and inter-rater correlations were analyzed. Bland Altman plots were drawn to visually determine the magnitude of differences in any given pair-wise measurements. RESULTS In this study, good inter-methods reliability was observed for almost all the examiners ranging from 0.907 to 0.918, except for one examiner (0.837). The greatest disagreements between the raters were observed for methods; CP (0.631) followed by CC (0.85), while the best agreements were observed for methods DP (0.9) followed by DC (0.872). CONCLUSION Variations in measurements between examiners can be reduced by using digital technologies when compared to conventional methods. Improved reproducibility of measurements obtained via intraoral scanning will increase the validity and reliability of future studies that compare different treatment modalities for root coverage.
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Affiliation(s)
- Hytham N Fageeh
- Division of Periodontics, College of Dentistry, Jazan University, P.O.Box 114, Jazan, 45142, Saudi Arabia.
| | - Abdullah A Meshni
- Division of Periodontics, College of Dentistry, Jazan University, P.O.Box 114, Jazan, 45142, Saudi Arabia
| | - Hassan A Jamal
- Division of Periodontics, College of Dentistry, Jazan University, P.O.Box 114, Jazan, 45142, Saudi Arabia
| | - Reghunathan S Preethanath
- Division of Periodontics, College of Dentistry, Jazan University, P.O.Box 114, Jazan, 45142, Saudi Arabia
| | - Esam Halboub
- Division of Periodontics, College of Dentistry, Jazan University, P.O.Box 114, Jazan, 45142, Saudi Arabia
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Makeeva IM, Budaychieva ZS, Polyakova MA, Margaryan EG, Novozhilova NE, Musiyev AA. [Special aspects of individual oral hygiene in patients with I class gingival recession]. STOMATOLOGIIA 2019; 98:25-28. [PMID: 31513144 DOI: 10.17116/stomat20199804125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
AIM To assess the efficacy of additional oral hygiene products in patients with gingival recession. MATERIAL AND METHODS 30 patients aged from 18 to 35 years with gingival recession participated in the study. The patients were distributed into 2 groups 15 patients in each depending on the use of brushes. The patients in the first group used manual toothbrush Curaprox CS 5460 together with single-tufted brush Curaprox CS 1006 as an additional means of oral hygiene. The patients in the second (control) group used only manual toothbrush Curaprox CS 5460. RESULTS No significant differences in the values of Silness-Löe and Navy-Rustogi indixes between groups were found at initial examination (p=0.713). However, the values of these hygienic indexes were significantly lower in the first group compared to the control group after 1 week and 1 month of the study (p<0.001). It was shown that oral hygiene in patients with gingival recession was significantly better in case of use of single-tufted brush. CONCLUSION Maximal efficacy of oral hygiene in patients with gingival grade 1 recession can be achieved by using manual toothbrush Curaprox CS 5460 together with single-tufted brush Curaprox CS 1006.
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Affiliation(s)
- I M Makeeva
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Z S Budaychieva
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - M A Polyakova
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - E G Margaryan
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - N E Novozhilova
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - A A Musiyev
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
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Huang JP, Liu JM, Wu YM, Chen LL, Ding PH. Efficacy of xenogeneic collagen matrix in the treatment of gingival recessions: A systematic review and meta-analysis. Oral Dis 2018; 25:996-1008. [PMID: 30076680 DOI: 10.1111/odi.12949] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 07/18/2018] [Accepted: 07/23/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVES This review aims to evaluate the efficacy of xenogeneic collagen matrix (XCM) for the treatment of single or multiple gingival recessions in terms of clinical parameters and patient-related outcomes. MATERIALS AND METHODS Various electronic databases (The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, etc.) from 1966 to April 2018 and hand literatures were searched. Quality of the included studies was assessed through the Cochrane Collaboration's Risk of Bias tool. A meta-analysis was performed to calculate risk ratios and mean differences. RESULTS Nine randomized controlled trials were included. The results revealed a higher percentage of mean root coverage (MRC) and a greater recession reduction (RecRed) for single recessions for the combination of coronally advanced flap (CAF) with XCM compared to CAF alone (n = 3; MD = 10.00%; 95%CI [3.56%; 16.43%]; p = 0.002) (n = 3; MD = 0.35 mm; 95%CI [0.10 mm; 0.60 mm]; p = 0.005). Comparing XCM with connective tissue graft (CTG), no significant differences were detected in MRC or RecRed for single and multiple recessions. CONCLUSIONS The addition of XCM under CAF could improve MRC and RecRed at single tooth recessions. Initial data suggest that XCM shows promising results to improve the clinical efficacy of CAF for multiple recessions. In addition, XCM could be a valid alternative to CTG in terms of MRC and RecRed at both single and multiple recessions. Based on limited evidence, XCM may decrease postoperative morbidity and operation time compared to CTG.
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Affiliation(s)
- Jia-Ping Huang
- Department of Periodontology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jia-Mei Liu
- Department of Periodontology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yan-Min Wu
- Department of Periodontology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Li-Li Chen
- Department of Periodontology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Pei-Hui Ding
- Department of Periodontology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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Yadav AP, Kulloli A, Shetty S, Ligade SS, Martande SS, Gholkar MJ. Sub-epithelial connective tissue graft for the management of Miller's class I and class II isolated gingival recession defect: A systematic review of the factors influencing the outcome. JOURNAL OF INVESTIGATIVE AND CLINICAL DENTISTRY 2018; 9:e12325. [PMID: 29424485 DOI: 10.1111/jicd.12325] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 12/24/2017] [Indexed: 06/08/2023]
Abstract
The aim of the present systematic review was to analyze the factors that affect the outcome of subepithelial connective tissue graft (SCTG) for managing Miller's class I and class II isolated gingival recession defect. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for systematic reviews were used. Quality assessments of selected articles were performed. Data on root surface condition, recession type defect, flap thickness, different flap designs, different harvesting techniques, presence/absence of the epithelial collar, graft thickness, flap tension, suturing techniques, and smoking-related outcomes on root coverage were assessed. The SCTG procedure provides the best root coverage outcomes for Miller's class I and class II recession. The critical threshold of flap thickness was found to be 1 mm. Maximum root coverage was achieved by envelope and modified tunnel technique. SCTG with the epithelial collar does not provide additional gains than SCTG without the epithelial collar. The thickness of SCTG for root coverage was found to be 1.5-2 mm. Greater flap tension and smoking adversely affect root coverage outcomes. Analysis of the factors discussed would be of key importance for technique selection, and a combined approach involving factors favoring outcomes of SCTG could be of clinical relevance in recession coverage.
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Affiliation(s)
- Anisha P Yadav
- Department of Periodontology, Dr. D Y Patil Dental College, Dr. D Y Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Anita Kulloli
- Department of Periodontology, Dr. D Y Patil Dental College, Dr. D Y Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Sharath Shetty
- Department of Periodontology, Dr. D Y Patil Dental College, Dr. D Y Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Shruti S Ligade
- Department of Periodontology, Dr. D Y Patil Dental College, Dr. D Y Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Santosh S Martande
- Department of Periodontology, Dr. D Y Patil Dental College, Dr. D Y Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Meenakshi J Gholkar
- Department of Periodontology, Dr. D Y Patil Dental College, Dr. D Y Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
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