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Results for “Gingival Recession”

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At least 109 records · Page 6Linked to original sources

PubMed2004

Coronally positioned flap with or without acellular dermal matrix graft in the treatment of Class I gingival recessions: a randomized controlled clinical study.

BACKGROUND: The aim of this study was to clinically evaluate the treatment of Class I gingival recessions by coronally positioned flap with or without acellular dermal matrix allograft (ADM). METHODS: Thirteen patients with comparable bilateral Miller Class I gingival recessions (> or = 3.0 mm) were selected. The defects were randomly assigned to one of the treatments: coronally positioned flap and acellular dermal matrix (ADM group) or coronally positioned flap alone (CPF group). The clinical parameters included: probing depth (PD), clinical attachment level (CAL), recession height (RH), recession width (RW), height of keratinized tissue (HKT), thickness of keratinized tissue (TKT), plaque index (PI), and gingival index (GI). The measurements were taken before the surgeries and after 6 months. RESULTS: The mean baseline recession was 3.4 mm and 3.5 mm for ADM group and CPF group, respectively. After 6 months, both treatments resulted in significant root coverage (P < 0.01), reaching an average of 2.6 mm (76%) in the ADM group and 2.5 mm (71%) in the CPF group. The difference in recession reduction between treatments was not statistically significant. There were no statistically significant differences between the treatments in PD, CAL, RH, RW, and HKT. However, the mean TKT gain was 0.7 mm for the ADM group and 0.2 mm for the CPF group (P < 0.01). CONCLUSION: It can be concluded that both techniques could provide significant root coverage in Class I gingival recessions; however, a greater keratinized tissue thickness can be expected with ADM.

Adult↗

PubMed1994

Characteristics of older adults experiencing periodontal attachment loss as gingival recession or probing depth.

While attachment loss currently is the best field examination indicator that periodontal disease has progressed, this measure is not disaggregated enough to differentiate between attachment loss that results in deeper pockets and attachment loss that results primarily in recession of the gingiva. If these two conditions have different etiologies, then efforts at predicting who will experience the condition from a single, general risk assessment model will be difficult. The purpose of this paper is to determine whether the characteristics of people who experience attachment loss primarily as increased probing depths are different from those people who experience attachment loss primarily as gingival recession. Baseline and 18-month follow-up periodontal measures were gathered on a representative sample of community-dwelling adults aged 65+. Based on measurement errors obtained one week apart on a reliability subsample, a threshold level of 3+mm was set to define attachment loss. Attachment loss was further characterized as resulting from mostly increased probing depth or from mostly increased gingival recession. In mesio-buccal sites, 58% of the people had attachment loss mostly due to increased probing depth with 42% having attachment loss mostly due to gingival recession. For buccal sites, the figures were 24% and 76% respectively. The logistic regression models for both sites indicated that people who had their attachment loss in the form of increased probing depths had different characteristics than people who had most of their attachment loss in the form of gingival recession.(ABSTRACT TRUNCATED AT 250 WORDS)

Black or African American↗

PubMed1994

Controlled clinical evaluation of the subpedicle connective tissue graft for the coverage of gingival recession.

The purpose of this study was to clinically evaluate the 1-year coverage of gingival recessions by a subpedicle connective tissue graft according to the original technique compared to untreated recessions by measuring probing sulcus depth (PSD), height of keratinized tissue (HKT), and mucogingival junction location changes. Paired gingival recessions were selected in 15 patients. In each patient, one recession was randomly assigned for treatment (test group) and the other recession was left untreated (control group) for 1 year. Surgery consisted of a connective tissue graft covered by a double papilla full thickness flap. Height of recession (HR), PSD, HKT, and cemento-enamel junction to mucogingival junction distance (CEJ-MGJ) were recorded with a calibrated probe before surgery and 1 year postoperatively. The control group showed no statistically significant differences in any of the parameters. In the test group, HR mean decreased significantly (P < 0.0006) from 3.66 mm to 1.09 mm, representing a mean root coverage of 70.5%. HKT mean increased significantly (P < 0.0006) from 1.60 mm to 4.30 mm, and PSD mean showed no statistical difference. CEJ-MGJ remained statistically unchanged. The subpedicle connective tissue graft may provide a good amount of root coverage and a substantial increase of keratinized tissue. Connective tissue grafted beneath the alveolar mucosa does not induce its transformation into keratinized gingival tissue.

Adult↗

PubMed2006

Clinical and anatomical factors limiting treatment outcomes of gingival recession: a new method to predetermine the line of root coverage.

Complete root coverage is not always achievable, even in gingival recession with no loss of interproximal attachment and bone. The cemento-enamel junction is the most widely used referring parameter to evaluate root coverage results. The aim of the present study was to describe the most frequent diagnostic mistakes that may lead to incomplete root coverage in Miller Class I and II gingival recessions and to suggest a method to predetermine the level/line of root coverage in non-molar teeth. The line of root coverage (i.e., the level/line to which the soft tissue margin will be positioned after the healing process of a root coverage surgical technique) was predetermined by calculating the ideal vertical dimension of the interdental papilla of the tooth with the recession defect. This method was applied to 120 recession-type defects affecting non-molar teeth of 80 young healthy subjects that were treated with root coverage surgical procedures over the last 5 years. All recessions were Miller Class I or II and were associated with at least one of the following characteristics: 1) traumatic loss of the tip of the interdental papilla(e); 2) tooth rotation; 3) tooth extrusion with or without occlusal abrasion; and 4) a cervical abrasion defect with no evidence of the cemento-enamel junction. The line of root coverage may be considered the clinical cemento-enamel junction because it may substitute the anatomic cemento-enamel junction when this is no longer clinically visible on the tooth with recession or when the ideal conditions to obtain complete root coverage are not fully represented.

Dental Occlusion, Traumatic↗

PubMedDate not supplied

Gingival recessions caused by lip piercing: case report.

Fear of losing the teeth is common among patients presenting with gingival recession. This report describes a case in which unusual gingival recessions were caused by lip piercing. Periodontal treatment involved removal of the causative agent, hygiene instruction, scaling and root planing, and coverage of the root with a subepithelial connective tissue graft. The therapeutic measures applied in this case yielded satisfactory root coverage, an increase in the width of the keratinized gingiva, improvement in hygiene status and absence of dental hypersensitivity.

Adult↗

PubMed2003

Gingival recessions caused by lip piercing: case report.

Adult↗

PubMed2006

Current trends in gingival recession coverage--part I: the tunnel connective tissue graft.

The recession of the gingiva is increasingly becoming a more prominent condition in the oral health of many patients and should be treated at its earliest detection. The multifactorial etiology, decision modality, and current trends followed in the treatment of gingival recession are discussed in this presentation. The correction of Class I and II gingival recessions are presented as a means of minimizing surgical trauma and achieving predictable aesthetic results. Part II of this discussion will present alternative techniques in treating gingival recession.

Adult↗

PubMed1980

Clinical evaluation of gingival recession treated by coronally repositioned flap technique.

Thirty-four areas of gingival recession in ten patients were treated by a coronally repositioned flap procedure. All but four of these areas had received a free gingiva graft previously. The postoperative evaluations of the wound healing were made at 2 weeks and at 1, 2, 4, 6 and 12 months after the final surgery. In most cases the amount of gingival recession was reduced with the average tissue gain being 1.82 mm. The gingival sulcus depth was unaffected by the procedure. Several cases showed total root coverage. Although the procedure described has many advantages, the authors feel these must be carefully weighed against the disadvantages before subjecting patients to such surgery.

Adult↗

PubMed2000

Ten-year evaluation of conservative and surgical treatment of gingival recession. A case series study.

In the last years the treatment of non-inflammatory periodontal diseases has greatly changed. Apico-coronal dimension of gingival tissue is not considered to be of utmost importance, but significance of tissue thickness over each tooth is stressed. Purpose of this study was to show results of conservative and surgical treatment of gingival recession. Sample consisted of two groups of subjects, which have been treated in one of stated ways during ten years. The data was obtained on the beginning and after ten years of recall. Both groups showed increased dimension of keratinized gingiva during observed time with decrease of gingival recession, plaque- and gingival index. It is considered that treatment should start with conservative measures with necessary motivation of the patients. If it does not show improvement, one should consider best surgical method available for each patient. Clinical results show success in both groups, meaning that treatment was properly decided on.

Gingival Recession↗

PubMed2000

Gingival recession treatment using a bilayer collagen membrane.

Traditional periodontal plastic surgery techniques for the management of gingival recession have typically used soft tissue grafts to obtain defect coverage with great clinical success. Clinicians using guided tissue regeneration (GTR) techniques are also enjoying significant success in periodontal plastic surgery procedures. GTR therapy utilizing bioabsorbable membranes offers the advantages of preventing a donor site surgery and a second surgical procedure for barrier removal. A new bioabsorbable bilayer collagen membrane that readily adapts to bone and tooth surfaces by a gel formation of collagen fibers and blood may be stabilized without sutures prior to soft tissue closure. This bioabsorbable membrane has been shown to be effective in guided bone regeneration procedures and in treating periodontal defects. This case demonstrates the treatment of gingival recession with a novel collagen bilayer membrane.

Absorbable Implants↗

PubMed2006

Gingival recession and pathologic migration due to an unusual habit.

Various etiologies are implicated as causes of gingival recession and pathological tooth migration, most prevalent among these being the tissue destruction caused by periodontal pathogens. One of the least documented causes is a parafunctional habit, such as digit-sucking or sucking on objects like pencils, pens or toothpicks, all of which can lead to adverse effects on the dentition and the periodontal tissues resulting in midline diastema, alveolar bone loss, gingival recession, mobility, and ultimately tooth loss. This case report describes the periodontal injury caused by an unusual habit of placing a coin between the mandibular anterior teeth. The potential effects of this habit on the dentition and periodontium are discussed; the preventive measures to be taken and the outline for the management of such cases, to ensure periodontal health of the patient are dealt with in this report.

Adolescent↗

PubMed1989

[Gingival recession, root caries and its prevalence].

In our study 150 referred patients were assessed for the presence of gingival recession and root caries. The mean age of the patients was 40 +/- 9 years. On average they failed 6.8 teeth. Gingival recession was present in all patients, with mean value of 55.5% denuded dental root surfaces, the most frequently expressed on buccal root surfaces. Number of denuded dental root surfaces increases with patient's age. The root caries lesion was found in 75% of patients. Patients had on average 5.7 treated and untreated caries lesions. The number of root caries lesions increases with age of the patients as well. The mean Index of total root caries was 9.4%. Most frequently root caries of lower molars and premolars was found, mostly on the buccal surfaces, rather than on approximal and lingual surfaces.

Adult↗

PubMed1978

Treatment of localized gingival recessions. Part I. Lateral sliding flap.

This study was undertaken to evaluate biometrically the changes that occur on the recipient as well as on the donor tooth with regard to gingival recession, sulcus depth and width of keratinized gingiva after performing a lateral sliding flap in the treatment of localized denuded roots. Fourteen teeth with gingival recession were treated using a lateral sliding flap. Measurements were recorded preoperatively and 1, 3 and 6 months after surgery. A mean gain of 2.69 mm of soft tissue coverage over the denuded root was found 6 months postoperatively which represents 69% of coverage. The mean gain in width of keratinized gingiva averaged 3.15 mm. On the donor tooth an average gingival recession of 1.1o mm was found after 6 months, and the width of keratinized gingiva decreased an average of 1.25 mm. Results remained stable after 30 days postsurgery.

Adult↗

PubMed2003

Use of acellular dermal matrix graft in the treatment of gingival recessions: a case report.

Case presentation in which a 12-years-old boy presented with two large gingival recessions on the maxillary central incisors, secondary to a lateral luxation. In the surgical procedure, an acellular dermal matrix graft (ADMG) was placed as a substitute for a free gingival graft. Twelve months later, complete root coverage was achieved, showing that ADMG, a biomaterial recently developed for mucogingival surgery, can be successfully used in the treatment of gingival recessions in pediatric patients.

Bicycling↗

PubMed2002

Localized gingival recession caused by a C-PAP mask: a case report.

This case report describes a localized gingival recession on the labial of tooth # 6 caused by the nasal mask of a C-PAP (Continuous Positive Air Pressure) machine. The patient was diagnosed with obstructive sleep apnea (OSA). Treatment consisted of night-time use of a C-PAP machine. The patient noticed sudden exposure of the root surface on no. 6 and sought evaluation by his family dentist. He was referred to a periodontist for evaluation. A subepithelial connective tissue graft was performed to repair the defect. A maxillary bite splint with a buccal and apical extension to protect the grafted area was constructed. The patient is able to wear the C-PAP mask and protective splint concurrently for successful treatment of his OSA and maintenance of the newly grafted connective tissue. We as dental practitioners can use this information to evaluate the etiology of gingival recession, especially those occurring in patients with OSA.

Connective Tissue↗

PubMed2003

Surgical therapies for the treatment of gingival recession. A systematic review.

BACKGROUND: A variety of soft tissue augmentation procedures directed at root coverage have been documented in the literature utilizing autogenous or allogenic soft tissue grafting or guided tissue regeneration (GTR). RATIONALE: The purpose of this systematic review was to assess the literature regarding the efficacies of various surgical gingival augmentation procedures relative to clinical and patient-oriented outcomes. FOCUSED QUESTION: What is the effect of surgical therapy for root coverage in patients with gingival recession compared with other treatment modalities or baseline values? SEARCH PROTOCOL: PubMed and the Cochrane Oral Health Group Trials Register were searched to identify human studies in English investigating the therapeutic use of a soft tissue surgical procedure to treat gingival recession. Searches were performed for articles published by April 2002. SELECTION CRITERIA: Initial screening of identified abstracts accepted all studies evaluating surgical intervention of gingival recession. Independent review by 2 reviewers evaluated full-text reports regarding study characteristics. Only those studies determined to be randomized clinical trials (RCTs) were included in the final analysis. DATA ANALYSIS AND COLLECTION: Outcome measures included changes in root coverage, clinical attachment levels (CAL), probing depth (PD), and width of keratinized tissue (KT). The only data suitable for meta-analysis were comparisons of the efficacy of connective tissue grafts with GTR. MAIN RESULTS: 1. Thirty-two articles (total study population: 687) met the criteria for RCTs: 11 (population: 286) related to various autogenous soft tissue augmentation procedures; 18 (population: 360) to GTR; and 3 (population: 41) to allogenic soft tissue augmentation. 2. Meta-analysis identified greater gains in both root coverage and keratinized tissue width for connective tissue graft procedures compared to GTR. 3. No other data were compatible with meta-analysis. REVIEWERS' CONCLUSIONS: 1. Soft tissue augmentation procedures are effective means of obtaining root coverage. 2. Connective grafting techniques appear to have an advantage over GTR. 3. There is a need for further efficacy studies and for investigation of these procedures relative to patient-oriented outcomes such as esthetics, root sensitivity, and postoperative morbidities.

Connective Tissue↗

PubMed2000

Coronally positioned flap procedures with or without a bioabsorbable membrane in the treatment of human gingival recession.

BACKGROUND: A variety of surgical techniques have been used to cover recession type defects. New data have indicated that the outcome of coronally positioned flap procedures may be augmented by supporting the flap with a membrane. METHODS: The present study aimed at comparing the clinical outcome following treatment of localized gingival recessions by a coronally positioned flap procedure alone, or combined with a bioabsorbable membrane. Twenty patients with buccal bilateral Miller Class I or Class II gingival recessions in cuspids or premolars participated in the study. The split-mouth design, randomized selection of site treatment, and blind evaluation provided 20 sites in a membrane group and 20 sites in a non-membrane group for examination at baseline, and at 3 months and 6 months postoperatively. Clinical variables included the apical extent of the gingival recession, the width of the recession defect measured at the cemento-enamel junction (CEJ), and the width of keratinized tissue at the recession site as well as probing depth and attachment level. RESULTS: Both treatments resulted in a significant gain (P <0.0001) of root coverage, amounting to an average of 2.3 mm in the membrane group and 2.5 mm in the non-membrane group at the 6-month evaluation. There was no significant difference between the treatments. Similarly, a significant gain of clinical attachment level was seen in the membrane (1.3 mm; P <0.001) as well as in the non-membrane (1.5 mm; P <0.0001) group, but without a significant difference between the groups. The reduction of the recession width from baseline to 6 months was significantly greater (P <0.01) for the non-membrane (2.3 mm) than for the membrane (1.4 mm) group. Probing depth changes were small and not significant for either of the treatments. When patients were grouped as smokers (8) and non-smokers (12), no significant differences were revealed for any of the response variables. Overall, among the 20 membrane sites, one showed no change while the remaining 19 gained root coverage at the 6-month examination. Five sites obtained coverage to the CEJ. Among the non-membrane sites, all gained root coverage at 6 months and 10 sites showed complete coverage to the CEJ. CONCLUSIONS: The coronally positioned flap operation offers a predictable, simple, and convenient approach as a root coverage procedure in Miller Class I and Class II recession defects. Combining this technique with the placement of a bioabsorbable membrane does not seem to improve the results following surgical treatment of such defects.

Absorbable Implants↗

PubMed2005

New surgical approach for root coverage of localized gingival recession with acellular dermal matrix: a 12-month comparative clinical study.

BACKGROUND: Acellular dermal matrix graft (ADMG) has been used as an advantageous substitute for autogenous subepithelial connective tissue graft (SCTG). However, the surgical techniques used were primarily developed for the SCTG, and they may not be adequate for ADMG since it has a different healing process than SCTG owing to its different vascular and cellular structures. This study compared the 1-year clinical outcome of a new surgical approach with the outcome of a conventional procedure for the treatment of localized gingival recessions, both performed using the ADMG. MATERIALS AND METHODS: The clinical parameters-probing depth, relative clinical attachment level, gingival recession (GR), and width of keratinized tissue-of 32 bilateral Miller Class I or II gingival recessions were assessed at baseline and 12 months postoperatively. RESULTS: Significant clinical changes for both surgical techniques were achieved after this period, including GR reduction from 3.4 mm presurgery to 1.2 mm at 1 year for the conventional technique and from 3.9 mm presurgery to 0.7 mm at 1 year for the new technique. The percentage of root coverage was 62.3% and 82.5% for the conventional and new techniques, respectively. Comparisons between the groups after this period by Mann-Whitney rank sum test revealed statistically significant greater reduction of GR favoring the new procedure (p = .000). CLINICAL SIGNIFICANCE: Based on the results of this study, it can be concluded that a new surgical technique using an ADMG is more suitable for root coverage when compared with the conventional technique. The results revealed a statistically significant improvement in clinical performance with the ADMG approach.

Adult↗