ABSTRACT
Connective tissue grafts (CTGs) are generally viewed as the most successful technique for root coverage. The aim of this retrospective study was to assess the long-term clinical and patient-centered esthetic results of the envelope technique for CTG. Thirty-nine defects in 20 patients (22 to 57 years of age; mean 37.8 +/- 11.5 years) had received CTG that had been harvested from the palate and grafted according to the envelope technique of Raetzke. Factors influencing root coverage were identified by multilevel analysis. The patients were also asked to judge the results of treatment. Follow-up examinations were performed 6 to 22 years (mean, 11.4 +/- 5.4 years) after surgery. Mean baseline recession was 3.1 +/- 1.3 mm (range, 1 to 6 mm). Clinical re-examination revealed mean root coverage of 89.7% +/- 25.1%. In 32 of 39 defects (82%), complete root coverage was achieved. Recessions were statistically significantly reduced by a mean of 2.7 +/- 1.2 mm (P < .001), to a postsurgical mean of 0.4 +/- 0.94 mm. Higher baseline Miller classes resulted in less favorable prognoses for complete and relative root coverage. Baseline recession height had a negative influence and location at a canine had a positive influence on the percentage of relative root coverage. All patients judged the situation at the respective teeth as improved.
Subject(s)
Gingiva/transplantation , Gingival Recession/surgery , Tooth Root/surgery , Adult , Connective Tissue/transplantation , Cuspid/pathology , Dentin Sensitivity/therapy , Esthetics, Dental , Female , Follow-Up Studies , Gingival Recession/classification , Gingival Recession/pathology , Gingivoplasty/methods , Humans , Incisor/pathology , Longitudinal Studies , Male , Middle Aged , Pain, Postoperative/etiology , Patient Satisfaction , Prognosis , Retrospective Studies , Treatment OutcomeABSTRACT
OBJECTIVE: To compare the subgingival microbiota of aggressive and chronic periodontitis (ChP) using single-site and pooled plaque samples. METHODS: In 60 patients with aggressive or ChP, subgingival plaque was sampled from the four deepest pockets using two sterile paper points simultaneously. One paper point from each pocket was put in a separate transport vial, the second was pooled with the three other paper points of a respective patient. The content of each vial was analysed for Aggregatibacter actinomycetemcomitans, Tannerella forsythensis, Porphyromonas gingivalis, and Treponema denticola. RESULTS: Pooled plaque samples detected higher numbers for all tested pathogens than single-site samples. Detection frequencies were similar for both strategies. Using single-site samples, A. actinomycetemcomitans detection rate was statistically significantly a higher in aggressive than in ChP (p=0.01). A. actinomycetemcomitans was found in higher numbers, the other pathogens in lower numbers in aggressive than in ChP. Neither presence nor absence of one of the tested bacteria had sufficient positive or negative predictive value for aggressive periodontitis. CONCLUSION: A. actinomycetemcomitans was detected in higher numbers and frequency in aggressive than in ChP. Its detection may confirm the clinical diagnosis and influence therapy. As a diagnostic test, its sensitivity and predictive value was low.
