Comparison of two techniques in gingival recession treatment: A randomized one-year clinical follow-up study.

BACKGROUND: Gingival recession (GR) is highly prevalent in the general population and represents a significant concern for patients and clinicians. Various surgical techniques have been proposed to treat gingival recession. Well-designed trials with clinicianand patient-based parameters, evaluating the envelope connective tissue graft (E-CTG) and semilunar coronally advanced flap (SCAF) techniques are still needed. OBJECTIVES: The aim of this trial was to compare the effectiveness of E-CTG and SCAF in the treatment of GR during a 1-year follow-up. MATERIAL AND METHODS: A total of 42 patients with GR were treated with E-CTG (n = 20) or SCAF (n = 22). Clinician-based recordings of recession depth (RD), recession width (RW), probing depth (PD), clinical attachment level (CAL), keratinized tissue width (KTW), tissue thickness (TT), clinical attachment gain (CAG), root coverage (RC), keratinized tissue change (KTC), and wound healing index (WHI), as well as patient-based parameters of dentine hypersensitivity (DH), tissue appearance, patient expectations, and esthetics were collected at baseline (BL), 6 weeks (T 1 ), 6 months (T 2 ), and 1 year (T 3 ). RESULTS: After the treatment, E-CTG demonstrated better outcomes than SCAF in terms of CAG (50.70% vs. 33.33%), RC (85.60% vs. 35.60%) and KTC (1.70 ±1.49 mm vs. 0.36 ±0.96 mm) at T 3 . Similar findings were detected in terms of WHI, tissue appearance, patient expectations, and esthetics. Although inconvenient surgical experience was recorded, better results were obtained after E-CTG in terms of DH and meeting the RC expectations. CONCLUSIONS: Despite it being more difficult surgical experience and the risk of keloid formation, E-CTG was superior to SCAF in terms of RC percentage, reducing DH and obtaining satisfactory RC. However, it is still necessary to improve patient comfort in the case of E-CTG.

The Adjunctive Effect of Platelet-Rich Fibrin to Connective Tissue Graft in the Treatment of Buccal Recession Defects: Results of a Randomized, Parallel-Group Controlled Trial.

BACKGROUND: Platelet-rich fibrin (PRF) is an autologous preparation that has encouraging effects in healing and regeneration. The aim of this trial is to evaluate the effectiveness of coronally advanced flap (CAF) + connective tissue graft (CTG) + PRF in Miller Class I and II recession treatment compared to CAF + CTG. METHODS: Forty patients were treated surgically with either CAF + CTG + PRF (test group) or CAF + CTG (control group). Clinical parameters of plaque index, gingival index, vertical recession (VR), probing depth, clinical attachment level (CAL), keratinized tissue width (KTW), horizontal recession (HR), mucogingival junction localization, and tissue thickness (TT) were recorded at baseline and 3 and 6 months after surgery. Root coverage (RC), complete RC (CRC), attachment gain (AG), and keratinized tissue change (KTC) were also calculated. RESULTS: All individuals completed the entire study period. At baseline, mean VR, HR, CAL, KTW, and TT values were similar (P >0.05). In both groups, all parameters showed significant improvement after treatment (P <0.001), and except TT (P <0.05), no intergroup difference was observed at 6 months after surgery. The amount of RC and AG, but not KTC and CRC, was higher in the PRF-applied group (P <0.05). CONCLUSIONS: According to the results, the addition of PRF did not further develop the outcomes of CAF + CTG treatment except increasing the TT. However, this single trial is not sufficient to advocate the true clinical effect of PRF on recession treatment with CAF + CTG, and additional trials are needed.

Forced eruption and implant site development in the aesthetic zone: A case report.

A multidisciplinary approach to develop the future implant site in the aesthetic zone was illustrated. A patient with perio-endo combined lesion at her upper central incisors was treated. Before extraction, forced eruption was performed and 12 months later, satisfactory amount of bone apposition was detected. At 2 weeks after atraumatic extraction, implants were placed and loaded with implant-supported restorations following osseous healing. Variables related to crown dimensions, periodontal/peri-implanter soft-tissue health and patient's aesthetic satisfaction were recorded at baseline, before extraction and after prosthetic treatment. At 12-month control, crown dimensions in the implant site were identical to the baseline and in addition to the healthy peri-implant tissues, successful aesthetics were obtained. Forced eruption is a successful non-invasive method to develop the aesthetics of the peri-implant tissues and implant-supported restorations.