Multiple root coverage with subepithelial connective tissue graft, 8-year follow-up: Case report.

Keywords: Root coverage, coronally advanced flap, connective tissue, non-Carious root lesions, multiple root coverage

Abstract

Some of the challenges of root coverage with connective tissue graft are donor site morbidity and patient discomfort from the surgical procedure, as well as poor patient cooperation in correcting and controlling precipitating and predisposing factors of gingival recession.

Objective: This case report shows a coronal displacement technique with a subepithelial connective tissue graft and a tunnel technique with a subepithelial connective tissue graft for root coverage of multiple maxillary and mandibular recessions, followed for 8 years.

Methodology: 44-year-old female patient, apparently healthy, presented with the query "My gums are going down and my teeth look longer", periodontal treatment was performed, scaling and root planing and subsequently root coverage with a displaced flap. coronal with and without graft of subepithelial connective tissue, tunnel technique with graft of subepithelial connective tissue and orthodontic treatment, periodontal support therapy was carried out 8 years after the surgical event.

Results: Results were obtained from 6 months, to the first, second and third year and finally in the eighth year, establishing periodontal health, healthy reduced periodontium, partial root coverage and aesthetic improvement, control of non-carious root lesions, absence of periodontal pockets and decreased dental sensitivity. The results of the percentage of root coverage in the eighth year, were comparable to those obtained in the 6 postoperative months, with the connective tissue graft technique in the postero-upper and lower teeth CTG plus CDF was 83.33%, in the postero-upper teeth of the left side, where the coronal displacement technique (CDF) was performed, obtained a coverage of 93.3%, as for the (CTG plus CDF) technique in upper anterior teeth it is 97.37%, CTG plus tunnel teeth Central and lateral incisors had 88% coverage percentage.

Conclusions: The root coverage technique with a coronal displacement collar with a graft of subepithelial connective tissue can be used successfully in the long term for the treatment of multiple gingival recessions, including reduced periodontium, obtaining in this clinical case partial coverage, allowing an aesthetic improvement. and considerable functional. of the patient at 8 years of follow-up.

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References

Imber JC, Kasaj A. Treatment of Gingival Recession: When and How? Int. Dent. J. 2021; 71(3): 178-87.

Romandini M, Soldini MC, Montero E, Sanz M. Epidemiology of mid-buccal gingival recessions in NHANES according to the 2018 World Workshop Classification System. J. Clin. Periodontol. 2020; 47(10): 1180–90.

Pini Prato G. Mucogingival deformities. Ann. Periodontol. 1999;4(1):98–101.

American Academy of Periodontology. (1992). Glossary of periodontal terms. American Academy of Periodontology.2019.

Seong J, Bartlett D, Newcombe RG, Claydon NCA, Hellin N, West NX. Prevalence of gingival recession and study of associated related factors in young UK adults. J. Dent. 2018; 76: 58–67.

Deo S, Shetty S, Kulloli A, Chavan R, Dholakia P, Ligade S, Dharmarajan G. Efficacy of free gingival graft in the treatment of Miller Class I and Class II localized gingival recessions: A systematic review. J. Indian. Soc. Periodontol. 2019; 23(2): 93–99.

West, N. X., Sanz, M., Lussi, A., Bartlett, D., Bouchard, P., & Bourgeois, D. Prevalence of dentine hypersensitivity and study of associated factors: a European population-based cross-sectional study. J. Dent.2013; 41(10):841–851.

Toledano-Osorio M, Muñoz-Soto E, Toledano M, Vallecillo-Rivas M, Vallecillo C, Ramos-García P, Osorio R. Treating Gingival Recessions Using Coronally Advanced Flap or Tunnel Techniques with Autografts or Polymeric Substitutes: A Systematic Review and Meta-Analysis. Polymers. Polymers. 2022;14(7):1453.

Jati AS, Furquim LZ, Consolaro A. Gingival recession: its causes and types, and the importance of orthodontic treatment. Dental. Press. J. Orthod. 2016;21(3):18-29.

Rana, T. K., Phogat, M, Sharma, T, Prasad, N., & Singh, S. Management of gingival recession associated with orthodontic treatment: a case report. JCDR.2014; 8(7): ZD05–ZD7.

Baer, P. N., & Benjamin, S. D. Gingival grafts: a historical note. Journal of periodontology, 1981;52(4):206–207.

Pini-Prato G, Nieri M, Pagliaro U, Giorgi TS, La Marca M, Franceschi, D., Buti, J, et al. Surgical treatment of single gingival recessions: clinical guidelines. Eur. J. Oral Implantol. (ANDI)2014;7(1):9–43.

Chambrone L, Salinas Ortega MA, Sukekava F, Rotundo R, Kalemaj Z, Buti J, Pini Prato GP. Root coverage procedures for treating localised and multiple recession-type defects. Cochrane Database Syst Rev. 2018;10(10)

Miller PD. A classification of marginal tissue recession. Int J Periodontics Restorative Dent 1985; 5: 8-13

Cairo, F., Nieri, M., Cincinelli, S., Mervelt, J., & Pagliaro, U.The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: an explorative and reliability study. Journal of clinical periodontology, 2011;38(7):661–666.

Cairo F, Cortellini P, Tonetti M, Nieri M, Mervelt J, Pagavino G, Pini-Prato G. Stability of root coverage outcomes at single maxillary gingival recession with loss of interdental attachment: 3-year extension results from a randomized, controlled, clinical trial. J of clin. Periodontol. 2015; 42(6):575–581.

Pi Pini-Prato G, Franceschi D, Cairo F, Nieri M, Rotundo R. Classification of dental surface defects in areas of gingival recession. J Periodontol 2010; 81: 885–890.

Mayta-Tovalino F, Barboza JJ, Pasupuleti V, Hernandez AV. Efficacy of Tunnel Technique (TUN) versus Coronally Advanced Flap (CAF) in the Management of Multiple Gingival Recession Defects: A Meta-Analysis. Int J Dent. 2023;2023:

Huamán-Mendoza, A, Reis, I, Ganhito, J, Carvalho C, Micheli, G., & Pannuti, C. M. (2023). Current state about root coverage using soft-tissue substitutes in the presence of noncarious cervical lesions: A literature review. J. Indian Soc. Periodontol.2023; 27(4): 344–351.

Pini Prato GP, Magnani C, Chambrone L. Long-term evaluation (20 years) of the outcomes of coronally advanced flap in the treatment of single recession-type defects. J Periodontol. 2018;89: 265–74.

Published
2024-08-13
How to Cite
Angeles Espinosa , I. Y. (2024). Multiple root coverage with subepithelial connective tissue graft, 8-year follow-up: Case report . Mexican Journal of Medical Research ICSA, 13(25). Retrieved from https://repository.uaeh.edu.mx/revistas/index.php/MJMR/article/view/12409