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Comparision of the effects of coronally repositioned flap techniques with releasing incision and without releasing incision for the treatment of localized gingival recession: 6 month controlled clinical study

Year 2014, Volume: 17 Issue: 3, 296 - 307, 06.08.2014

Fatma Böke , Murat Akkaya

https://doi.org/10.7126/cdj.58140.1008002003

Abstract

Objectives: The aim of the present study was to compare clinical outcomes of split thickness coronally repositioned flap (CRF) without vertical releasing incisions and full thickness CRF with vertical releasing incisions in the treatment of localized gingival recessions.

Materials and Methods: Nineteen systemically and periodontally healthy patients with bilateral Miller class I recession defects were enrolled in the study. Control recession defects were treated full thickness CRF with vertical releasing incisions and test recession defects were treated split thickness CRF without vertical releasing incissions. Porbing depth (PD), Recession depth (RD), Recession width (RW), Keratinized tissue width (KTW) and Clinical athacment level
(CAL) were measured at baseline and 3 and 6 months after the treatment.

Results: Both groups showed statistically significant gain in Clinical Athacment Level and statistically significant reduction in Recession Depth, Recession Width, Probing Depth. The differences between groups were not statistically significant for Recession Depth; Recession Width; Probing Depth; Keratinized Tissue Width and Clinical Athacment Level after 6 months.

Conclusion: This clinical study showed that, modified CRF technique is as effective as clasical CRF technique for the treatment of localized gingival recession.

Keywords

Coronally repositioned flap Gingival recession Mucogingival surgery

References

  • KAYNAKLAR
  • - The American Academy of Periodontology. Glossary of Periodontal Terms 4th eddition. Chicago 2001: The American Academy of Periodontology.
  • - Allen EP, Miller PD. Coronal positioning of existing gingiva: shot-term results in the treatment of shallow marginal tissue recession. J Periodontol 1989;60:316-319.
  • - Sullivan H, Atkins J. Free autogenous gingival grafts. III. Utilization of grafts in teh treatment of gingival recession. Periodontics 1968;6:152-160.
  • - Langer B, Langer L. Subepithelial connective tissue graft technique for root coverage. J Periodontol 1985;56:715-720.
  • - Pini Prato G, Tinti C, Vincenzi G, Magnani C, Cortellini P, Clauser C. Guided tissue regeneration in gingival recessions. Periodontology 2000 1992;11:49-57.
  • - Keceli HG, Sengün D, Berberoğlu A., Karabulut E. Use of platelet gel with connective tissue graft for root coverage: A randomized-controlled trial. J Clin Periodontol 2008;35: 255-262.
  • - Tunalı M, Ataoğlu T, Ozdemir H. Derin miller sınıf II dişeti çekilmelerin çift cerrahi yöntemle tedavisi: Bir olgu sunumu. Cumhuriyet Üniversitesi Diş Hek. Fak. Dergisi 2009;2:129-131.
  • - Harris RJ, Harris AW. The coronally positioned pedicle graft with inlaid margins: A predictable method of obtaining root coverage of shallow defects. Int J Per Rest Dent 1994;14: 228-241
  • - Miller PD. A classification of marginal tissue recession. Int J Per Rest Dent 1985;5:8-13.
  • - Saletta D, Pini Prato G, Pagliaro U, Baldi C, Mauri M, Nieri M. Coronally advanced flap procedure: Is the interdental papilla a prognostic factor for root coverage? J Periodontol 2001;72:760-766.
  • - Holbrook T, Ochsenbein C. Complete coverage of the denuded root surface with a one stage gingival graft. Int J Per Rest Dent 1983;5: 9-27.
  • - Trombelli L. Schincaglia GP, Scapoli C, Calura G. Healing response of human bukkal gingival recessions treated with expanded polytetrafluoroethylene membranes. A retrospective report. J Periodontol 1995;66:14-22.
  • - Hwang D, Wang H. Flap thickness as a predictor of rooot coverage: A systemetic review. J Periodontol 2006;77:1625-1634.
  • - Mörmann W, Ciancio SG. Blood suply of human gingiva following periodontal surgery. A fluorescein angiographic study. J Periodontol 1977;48:681-692.
  • - Zucchelli G, de Sanctis M. Treatment of multiple recession-type defects in patients with esthetic demands. J Periodontol 2000;71:1506-151.
  • - de Sanctis M, Zucchelli G. Coronally advanced flap: a modified surgical approach for isolated recession-type defects: three-year results. J Clin Periodontol 2007;34:262-268.
  • - Raetzke PB. Covering localized areas of root exposure employing the‘envelope’ technique. J Periodontol 1985;56:397-402.
  • - Tarnow DP. Semilunar coronally repositioned flap. J Clin Periodontol 1986;13:182-185.
  • - Zucchelli G, Mele M, Mazotti C, Marzadori M, Montebugnoli L, de Sanctis M. Coronally advanced flap with and without vertical releasing incisions for the treatment of multiple gingival recessions: a comperative controlled randomized clinical trial. J Periodontol 2009;80:1083-1094.
  • - Cortellini P, Tonetti M, Baldi C, Francetti L, Rasperini G, Nieri M, Franceschi D, Labriola A, Pini Prato G. Does placement of a connective tissue graft improve the outcomes of coronally advanced flap for coverage of single gingival recessions in upper anterior teeth? A multi-centre, randomized, double-blind, clinical trial. J Clin Periodontol 2009;36:68-79.
  • - Baldi C, Pini Prato G, Pagliaro U, Nieri M, Saletta LM, Cortellini P. Coronally advanced flap procedure for root coverage. Is the flap thickness a relevant predictor to achieve root coverage? A 19- case series J Periodontol 1999;70:1077-1084.
  • - Gürgan AC, Oruç AM, Akkaya M. Alterations in location of the mucogingival junction 5 years after coronally repositioned flap surgery. J Periodontol 2004;75: 893-901.
  • - Huang LH, Neiva REF, Wang HL. Factors affecting the outcomes of coronally advanced flap root coverage procedure. J Periodontol 2005;76: 1729-1734.
  • - Wensstrom JL, Zucchelli G. Increased gingival dimension. A significant factor for successful outcome of root coverage procedures? A 2- year prospective clinical study. J Clin Periodontol 1996;23:770-777.
  • - McGuire MK, Scheyer ET. Xenogeneic collagen matrix with coronally advanced flap compared to connective tissue with coronally advanced flap fort he treatment of dehissence-type recession defects. J Periodontol 2010;81:1108-1117.
  • - Baloş K., Özcan G, Baran C. Farklı yöntemlerle ölçülen keratinize dişeti genişliğine ait değerlerin karşılaştırılması. G Ü Dişhek Fak Dergisi 1984;1:37-44.
  • - Pini Prato G, Pagliaro U, Baldi C, Nieri M, Saletta LM, Cairo F, Cortellini P. Coronally advanced flap procedure for root coverage. Flap with tension versus flap without tension: A randomized cotrolled clinical study. J Periodontol 2000;71:188-201.
  • - Pini Prato G, Baldi C, Nieri M, Franseschi D, Cortellini P, Clauser C, Rotundo R, Muzzi L. Coronally advanced flap: The post-surgical position of the gingival magrin ıs an ımportant factor for achieving complete root coverage. J Periodontol 2005;76:713-722.
  • - Santana RB, Furtado MB, Mattos CML, Fonseca EM, Dibart S. Clinical evaluation of singlstage advanced versus rotatet flaps in the treatment of gingival recessions. J Periodontol 2010;81:485-492.
  • - Saletta D, Pini Prato G, Pagliaro U, Baldi C, Mauri M, Nieri M. Coronally advanced flap procedure: Is the interdental papilla a prognostic factor for root coverage? J Periodontol 2001;72:760-766.
  • - Karring T, Cumming BR, Oliver RC, Löe H. The origin of granulation tissue and its impact on postoperative results of mucogingival surgery. J Periodontol 1975b;46: 577-585.
  • - Wood DL, Hoag PM, Donnenfeld OW, Rosenfeld LD. Alveolar crest reduction folowing full and partial thickness flaps. J Periodontol 1972;42:141-144.
  • - Wennström J, Lindhe J. Role of attached gingiva for maintenance of periodontal health. Healing following excisional and grfating procedures in dogs. J Clin Periodontol 1983a;10:206-221.
  • - Cairo F, Pagliaro U, Nieri M. Treatment of gingival recession with coronally advanced flap procedures: a systematic review. J Clin Periodontol 2008;35:136-162.
  • - Lins LHS, de Lima AFM, Sallum AW. Root coverage: comparision of coronally positioned flap with and without titanium-reinforced barrier membrane. J Periodontol 2003;74:168-174.
  • - Pini Prato G, Cairo F, Nieri M, Franseschi D, , Rotundo R, Cortellini P. Coronally advanced flap versus connective tissue graft in the treatment of multiple gingival recessions: a split- mouth study with a 5-year follow-up. J Clin Periodontol 2010;37: 644-650.
  • - Zabalegui I, Sicilia A, Cambra J, Gil J, Sanz M. Treatment of multiple adjacent gingival recessions with the tunnel subepithelial connective tissue graft: a clinical report. Int J Per Rest Dent 1999;19:199-206.

Lokalize dişeti çekilmelerinin tedavisinde gevşetme insizyonlu ve gevşetme insizyonsuz kuronale repozisyone flep tekniklerinin etkinliklerinin karşılaştırılması: 6 aylık kontrollü klinik çalışma

Year 2014, Volume: 17 Issue: 3, 296 - 307, 06.08.2014

Fatma Böke , Murat Akkaya

https://doi.org/10.7126/cdj.58140.1008002003

Abstract

Amaç: Bu klinik çalışmanın amacı, lokalize dişeti çekilmelerinin tedavisinde vertikal gevşetme insizyonları yapılmadan hazırlanan ve yarım kalınlık olarak kaldırılan modifiye Kuronale Repozisyone Flep (KRF) tekniği ile vertikal gevşetme insizyonu yapılan ve tam kalınlık olarak kaldırılan KRF tekniğinin karşılaştırılmasıdır.

Gereç ve Yöntem: Bilateral Miller Sınıf I lokalize bukkal dişeti çekilmesi olan, periodontal ve sistemik olarak sağlıklı, 19 birey çalışmaya dahil edilmiştir. Kontrol çekilme defektleri tam kalınlık olarak kaldırılan ve vertikal gevşetme insizyonu yapılan KRF tekniği ile tedavi edilirken test grubundaki defektler, yarım kalınlık olarak kaldırılan ve vertikal gevşetme insizyonu yapılmayan KRF tekniği ile tedavi edilmiştir. Cep derinliği (CD), Çekilme Derinliği (ÇD), Çekilme Genişliği (ÇG), Keratinize Dişeti Genişliği (KDG) ve Klinik Ataçman Seviyesi (KAS) başlangıçta ve tedaviden 3 ve 6 ay sonra ölçülmüştür.

Sonuçlar: Bu klinik çalışmanın sonuçları lokalize dişeti çekilmelerinin tedavisi için uygulanan modifiye KRF tekniğinin klasik KRF tekniği kadar etkili bir teknik olduğunu göstermektedir.

Sonuç: Bu klinik çalışmada modifiye KBY tekniği lokalize dişeti çekilmesi tedavisinde klasik CRF tekniği kadar etkili olduğunu gösterdi.

Keywords

Dişeti çekilmesi Kuronale Repozisyone Flep Mukogingival cerrahi

References

  • KAYNAKLAR
  • - The American Academy of Periodontology. Glossary of Periodontal Terms 4th eddition. Chicago 2001: The American Academy of Periodontology.
  • - Allen EP, Miller PD. Coronal positioning of existing gingiva: shot-term results in the treatment of shallow marginal tissue recession. J Periodontol 1989;60:316-319.
  • - Sullivan H, Atkins J. Free autogenous gingival grafts. III. Utilization of grafts in teh treatment of gingival recession. Periodontics 1968;6:152-160.
  • - Langer B, Langer L. Subepithelial connective tissue graft technique for root coverage. J Periodontol 1985;56:715-720.
  • - Pini Prato G, Tinti C, Vincenzi G, Magnani C, Cortellini P, Clauser C. Guided tissue regeneration in gingival recessions. Periodontology 2000 1992;11:49-57.
  • - Keceli HG, Sengün D, Berberoğlu A., Karabulut E. Use of platelet gel with connective tissue graft for root coverage: A randomized-controlled trial. J Clin Periodontol 2008;35: 255-262.
  • - Tunalı M, Ataoğlu T, Ozdemir H. Derin miller sınıf II dişeti çekilmelerin çift cerrahi yöntemle tedavisi: Bir olgu sunumu. Cumhuriyet Üniversitesi Diş Hek. Fak. Dergisi 2009;2:129-131.
  • - Harris RJ, Harris AW. The coronally positioned pedicle graft with inlaid margins: A predictable method of obtaining root coverage of shallow defects. Int J Per Rest Dent 1994;14: 228-241
  • - Miller PD. A classification of marginal tissue recession. Int J Per Rest Dent 1985;5:8-13.
  • - Saletta D, Pini Prato G, Pagliaro U, Baldi C, Mauri M, Nieri M. Coronally advanced flap procedure: Is the interdental papilla a prognostic factor for root coverage? J Periodontol 2001;72:760-766.
  • - Holbrook T, Ochsenbein C. Complete coverage of the denuded root surface with a one stage gingival graft. Int J Per Rest Dent 1983;5: 9-27.
  • - Trombelli L. Schincaglia GP, Scapoli C, Calura G. Healing response of human bukkal gingival recessions treated with expanded polytetrafluoroethylene membranes. A retrospective report. J Periodontol 1995;66:14-22.
  • - Hwang D, Wang H. Flap thickness as a predictor of rooot coverage: A systemetic review. J Periodontol 2006;77:1625-1634.
  • - Mörmann W, Ciancio SG. Blood suply of human gingiva following periodontal surgery. A fluorescein angiographic study. J Periodontol 1977;48:681-692.
  • - Zucchelli G, de Sanctis M. Treatment of multiple recession-type defects in patients with esthetic demands. J Periodontol 2000;71:1506-151.
  • - de Sanctis M, Zucchelli G. Coronally advanced flap: a modified surgical approach for isolated recession-type defects: three-year results. J Clin Periodontol 2007;34:262-268.
  • - Raetzke PB. Covering localized areas of root exposure employing the‘envelope’ technique. J Periodontol 1985;56:397-402.
  • - Tarnow DP. Semilunar coronally repositioned flap. J Clin Periodontol 1986;13:182-185.
  • - Zucchelli G, Mele M, Mazotti C, Marzadori M, Montebugnoli L, de Sanctis M. Coronally advanced flap with and without vertical releasing incisions for the treatment of multiple gingival recessions: a comperative controlled randomized clinical trial. J Periodontol 2009;80:1083-1094.
  • - Cortellini P, Tonetti M, Baldi C, Francetti L, Rasperini G, Nieri M, Franceschi D, Labriola A, Pini Prato G. Does placement of a connective tissue graft improve the outcomes of coronally advanced flap for coverage of single gingival recessions in upper anterior teeth? A multi-centre, randomized, double-blind, clinical trial. J Clin Periodontol 2009;36:68-79.
  • - Baldi C, Pini Prato G, Pagliaro U, Nieri M, Saletta LM, Cortellini P. Coronally advanced flap procedure for root coverage. Is the flap thickness a relevant predictor to achieve root coverage? A 19- case series J Periodontol 1999;70:1077-1084.
  • - Gürgan AC, Oruç AM, Akkaya M. Alterations in location of the mucogingival junction 5 years after coronally repositioned flap surgery. J Periodontol 2004;75: 893-901.
  • - Huang LH, Neiva REF, Wang HL. Factors affecting the outcomes of coronally advanced flap root coverage procedure. J Periodontol 2005;76: 1729-1734.
  • - Wensstrom JL, Zucchelli G. Increased gingival dimension. A significant factor for successful outcome of root coverage procedures? A 2- year prospective clinical study. J Clin Periodontol 1996;23:770-777.
  • - McGuire MK, Scheyer ET. Xenogeneic collagen matrix with coronally advanced flap compared to connective tissue with coronally advanced flap fort he treatment of dehissence-type recession defects. J Periodontol 2010;81:1108-1117.
  • - Baloş K., Özcan G, Baran C. Farklı yöntemlerle ölçülen keratinize dişeti genişliğine ait değerlerin karşılaştırılması. G Ü Dişhek Fak Dergisi 1984;1:37-44.
  • - Pini Prato G, Pagliaro U, Baldi C, Nieri M, Saletta LM, Cairo F, Cortellini P. Coronally advanced flap procedure for root coverage. Flap with tension versus flap without tension: A randomized cotrolled clinical study. J Periodontol 2000;71:188-201.
  • - Pini Prato G, Baldi C, Nieri M, Franseschi D, Cortellini P, Clauser C, Rotundo R, Muzzi L. Coronally advanced flap: The post-surgical position of the gingival magrin ıs an ımportant factor for achieving complete root coverage. J Periodontol 2005;76:713-722.
  • - Santana RB, Furtado MB, Mattos CML, Fonseca EM, Dibart S. Clinical evaluation of singlstage advanced versus rotatet flaps in the treatment of gingival recessions. J Periodontol 2010;81:485-492.
  • - Saletta D, Pini Prato G, Pagliaro U, Baldi C, Mauri M, Nieri M. Coronally advanced flap procedure: Is the interdental papilla a prognostic factor for root coverage? J Periodontol 2001;72:760-766.
  • - Karring T, Cumming BR, Oliver RC, Löe H. The origin of granulation tissue and its impact on postoperative results of mucogingival surgery. J Periodontol 1975b;46: 577-585.
  • - Wood DL, Hoag PM, Donnenfeld OW, Rosenfeld LD. Alveolar crest reduction folowing full and partial thickness flaps. J Periodontol 1972;42:141-144.
  • - Wennström J, Lindhe J. Role of attached gingiva for maintenance of periodontal health. Healing following excisional and grfating procedures in dogs. J Clin Periodontol 1983a;10:206-221.
  • - Cairo F, Pagliaro U, Nieri M. Treatment of gingival recession with coronally advanced flap procedures: a systematic review. J Clin Periodontol 2008;35:136-162.
  • - Lins LHS, de Lima AFM, Sallum AW. Root coverage: comparision of coronally positioned flap with and without titanium-reinforced barrier membrane. J Periodontol 2003;74:168-174.
  • - Pini Prato G, Cairo F, Nieri M, Franseschi D, , Rotundo R, Cortellini P. Coronally advanced flap versus connective tissue graft in the treatment of multiple gingival recessions: a split- mouth study with a 5-year follow-up. J Clin Periodontol 2010;37: 644-650.
  • - Zabalegui I, Sicilia A, Cambra J, Gil J, Sanz M. Treatment of multiple adjacent gingival recessions with the tunnel subepithelial connective tissue graft: a clinical report. Int J Per Rest Dent 1999;19:199-206.
There are 38 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Case Reports
Authors

Fatma Böke

Murat Akkaya

Publication Date August 6, 2014
Submission Date February 18, 2013
Published in Issue Year 2014Volume: 17 Issue: 3

Cite

EndNote Böke F, Akkaya M (August 1, 2014) Lokalize dişeti çekilmelerinin tedavisinde gevşetme insizyonlu ve gevşetme insizyonsuz kuronale repozisyone flep tekniklerinin etkinliklerinin karşılaştırılması: 6 aylık kontrollü klinik çalışma. Cumhuriyet Dental Journal 17 3 296–307.

Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.


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