Treatment of deep single RT2 and RT3 antero-mandibular gingival recessions with a combination of surgical techniques: A case series study

OBJECTIVE

To evaluate root coverage (RC) in deep single antero-mandibular RT2 and RT3 gingival recessions (GR) and to investigate the influence of several factors in RC.

MATERIALS AND METHODS

Fifteen single antero-mandibular GR with a minimum depth of 3 mm were consecutively treated with a new one-stage technique (laterally positioned flap with a tunnel access and a connective tissue graft). At baseline and at 12-month follow-up, the percentage of mean root coverage (%MRC), the recession reduction (RecRed), complete root coverage (CRC) and the gain of keratinized tissue width (KTW) were assessed. Descriptive, intergroup comparative and correlation analyses were performed.

RESULTS

At 12 months, a %MRC of 77.29 ± 21.48% with a mean RecRed of 4.10 ± 1.51 mm was achieved. The %MRC was 84.71 ± 21.08% in RT2, and 62.43 ± 14.17% in RT3. The mean gain of KTW was 2.10 ± 0.89 mm, with a mean gain of 2.0 ± 1.03 mm for RT2 and 2.3 ± 0.57 mm for RT3. CRC was observed in six cases, all of them being RT2. A positive association was found between the %MRC and the initial position of the tooth and of both papillae.

CONCLUSIONS

This technique might be a valuable approach for the treatment of deep single antero-mandibular RT2 and RT3 recessions, even in malpositioned teeth.

CLINICAL SIGNIFICANCE

A combination of different surgical techniques could provide greater vascularization to the CTG especially in malpositioned teeth in sextant V with a large avascular area to be covered.

Postorthodontic stability of the new attachment achieved by guided tissue regeneration following orthodontic movement: report of 2 cases

Orthodontic treatment was provided after guided tissue regeneration of intrabony defects in 2 patients with periodontal disease. The new attachment obtained by guided tissue regeneration remained stable when subjected to orthodontic forces.

Periodontal regeneration of intrabony defects using resorbable membranes: determinants of the healing response. An observational clinical study

The safety and bone-regenerative capacity of a resorbable membrane (Resolut) was evaluated by a nonrandomized prospective clinical study of patients with periodontal defects. Prior to surgical management all patients underwent scaling and root planing and were instructed on oral hygiene. The study included 18 patients (31 periodontal defects) who received surgical treatment by guided tissue regeneration (GTR) using resorbable membranes. The results were evaluated 12 months after surgery in terms of Plaque Index, bleeding index, probing depth, gingival recession, clinical attachment level, and dental mobility. The results obtained show that the use of resorbable membranes in GTR causes few complications. The mean gain in clinical attachment level (4.06 +/- 1.91 mm), with an attachment level gain of more than 3 mm in 81.2% of the defects, suggests the presence of "new attachment." This difference was clinically and statistically significant (t = 11.03, P = 0). The multivariate regression study showed that 60% of the observed variability (F = 11.48, P < 0.001) in clinical attachment level gain was accounted for by the variable's initial probing depth, the Plaque Index of the tooth subjected to GTR, and the infrabony component of the defect.