Localized gingival recessions treated with the original envelope technique: a report of 50 consecutive patients.

BACKGROUND: The surgical techniques used to treat gingival recession have changed considerably in the last 50 years. The envelope technique described nearly 20 years ago still offers an excellent alternative for the problem of recession. The purpose of this retrospective study is to show the results of 115 recession sites treated in 50 patients using the envelope technique. METHODS: One hundred-fifteen consecutive procedures were performed in 50 patients in a private practice in the last 5 years using the envelope technique. Briefly, the teeth are scaled, a split thickness flap is performed around the recession, a subepithelial connective tissue graft is harvested from the palate and placed over the recession, and sutured with 6-0 silk. Four cases representing different types of recession will be reviewed and all cases will be analyzed. RESULTS: In general, this surgical method provided excellent root coverage and an increased amount of keratinized gingiva. The complete root coverage mean was 85%, 65%, and 16% for recession Class I, II, and IV, respectively. CONCLUSION: The cases support the use of the envelope technique to treat different types of single and multiple recessions.

Immediate replacement of single upper posterior teeth: a report of cases.

BACKGROUND: The immediate replacement of upper molar teeth with implants poses a significant challenge to the clinician because of its sinus involvement. PURPOSE: The purpose of this article is to report a protocol in which single molar teeth are replaced immediately with implants, minimizing the need for other surgical procedures. MATERIALS AND METHODS: This protocol has been employed in eight cases. Briefly, the teeth are extracted atraumatically, the sockets evaluated, an osteotomy performed following the direction of the socket, and a wide diameter implant placed using the socket walls and sinus floor to anchor it. A grafting material is placed when the space between implant and socket wall is considerably large. Three cases are reviewed here, and all eight are summarized. RESULTS: All cases have excellent soft and hard tissue healing after 6 months. Furthermore, the overall time needed to restore the cases has been considerably reduced and the need for sinus management eliminated. CONCLUSION: The cases presented support the use of the described protocol in the placement of implants in maxillary molar areas without any other sinus procedures.

Preservation of esthetics with implant dentistry: a clinical report.

BACKGROUND: The replacement of single teeth with implants in the anterior maxilla poses a significant challenge to the clinician because of its esthetic implications. PURPOSE: The purpose of this article is to report a protocol in which single teeth are replaced by implants and temporarily restored without load, immediately after extraction. MATERIALS AND METHODS: Between June 2001 and July 2002, 16 cases were followed up in which this protocol was used. Briefly, the teeth are extracted with a Periotome (Friadent, Mannheim, Germany), using a flapless technique, the sockets are evaluated and débrided, an osteotomy is performed following the direction of the socket, and a tapered implant is placed using the alveolar crest as the landmark. A temporary abutment is immediately custom made, and a temporary crown is placed without loading. The 16 cases are summarized, and 4 of them are presented to illustrate this approach. RESULTS: All four cases have provided excellent esthetic results maintaining an ideal implant-to-supporting-tissue relationship. Furthermore, the overall time needed to restore the cases was considerably reduced when compared with time needed for the conventional approach. CONCLUSION: The four cases presented support the use of the described protocol in the placement of single implants in areas of the maxillary anterior region where esthetics is a high priority.