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Multiple recession coverage with tunnel technique and subepithelial connective tissue graft – case report
Bartłomiej Górski, Tomasz Kaczyński
Streszczenie
Recesje dziąsłowe są powszechnym problemem w praktyce klinicznej i mogą prowadzić do licznych powikłań estetycznych i stomatologicznych. Złotym standardem postępowania w przypadku mnogich recesji dziąsłowych jest technika dokoronowo przesuniętego płata z wykorzystaniem przeszczepu autologicznej podnabłonkowej tkanki łącznej. Jednak ze względu na potencjalne powikłania estetyczne związane z cięciami pionowymi oraz cięciami w obszarze brodawek alternatywę dla leczenia mnogich recesji dziąsłowych mogą stanowić techniki: kopertowa bądź tunelowa. Celem pracy było przedstawienie planowania leczenia mnogich recesji dziąsłowych oraz prezentacja przypadku pokrycia recesji z wykorzystaniem techniki tunelowej i przeszczepu podnabłonkowej tkanki łącznej.
Abstract
Multiple gingival recessions are common finding in clinical practice and can lead to many aesthetic and dental complications. Coronally advanced flap technique with autologous subepithelial connective tissue graft is considered as “the gold standard” in treatment of multiple gingival recessions. However, vertical releasing incisions and papillae incisions could lead to aesthetic compromises and thus tunnel technique could be alternative treatment method. The aim of this article was to discuss treatment planning of multiple gingival recessions and to present case of recession coverage with the use of tunnel technique and subepithelial connective tissue graft.
Hasła indeksowe: mnogie recesje dziąsłowe, technika tunelowa, przeszczep podnabłonkowej tkanki łącznej, leczenie ortodontyczne
Key words: multiple gingival recessions, tunnel technique, subepithelial connective tissue graft, orthodontic treatment
1. Wennstrom J.L.: Mucogingival Surgery. (w:) Lang N.P., Karring T., editors. Proceedings of the 1st European Workshop on Periodontology. Quintessence , London 1994, 193-209.
2. Serino G., Wennström J.L., Lindhe J., Eneroth L.: The prevalence and distribution of gingival recession in subjects with a high standard of oral hygiene. J. Clin. Periodontol., 1994, 21, 57-63.
3. Yoneyama T., Okamoto H., Lindhe J. i wsp.: Probing depth, attachment loss and gingival recession. J Clin Periodontol; 1988; 15; 581–91.
4. Kassab M.M., Cohen R.E.: The etiology and prevalence of gingival recession. J. Am. Dent. Assoc.,2003; 134; 220-5
5. Gillam D., Chesters R., Attrill D. i wsp.: Dentine hypersensitivity – guidelines for the management of a common oral health problem. Dentistry Update, 2013, 40, 514-516, 518-520, 523-524.
6. Wennström J.L., Lindhe J., Sinclair F. i wsp.: Some periodontal tissue reactions to orthodontic tooth movement in monkeys. J. Clin. Periodontol.,1987, 14, 121-129.
7. Joss-Vassalli I., Grebenstein C., Topouzelis N. i wsp.: Orthodontic therapy and gingival recession: a systematic review. Orthod. Craniofac. Res., 2010, 13, 127-141.
8. Johal A., Katsaros C., Kiliaridis S. i wsp.: State of the science on controversial topics: orthodontic therapy and gingival recession (a report of the Angle Society of Europe 2013 meeting). Progress in Orthodontics, 2013, 14, 16.
9. Chambrone L., Sukekava F., Araújo M.G.: Root coverage procedures for the treatment of localised recession-type defects. Cochrane Database Syst. Rev., 2009, 15, 2, CD007161.
10. Chambrone L., Tatakis D.N.: Periodontal soft tissue root coverage procedures: a systematic review from the AAP Regeneration Workshop. J. Periodontol., 2015, 86, 2, 8-51.
11. Cairo F., Cortellini P., Tonetti M.: Coronally advanced flap with and without connective tissue graft for the treatment of single maxillaary gingival recession with loss of inter-dental attachment. A randomized controlled clinical trial. J. Clin. Periodontol., 2012, 39, 8, 760-768.
12. Aroca .S, Keglevich T., Nikolidakis D.: Treatment of Class III multiple gingival recessions: a randomized-clinical trial. J. Clin. Periodontol., 2010, 37, 88-97.
13. Nordland W.P., Tarnow D.P.: A classification system for loss of papillary height. J. Periodontol., 1998, 69, 10, 1124-1126.
14. Ozcelik O., Seydaoglu G., Haytac M.C.: An explorative study to develop a predicitive model based on avascular exposed root surface area for root coverage after a laterally positioned flap. J. Periodontol., 2015, 86, 356-366.
15. Tatakis D.N., Chambrone L., Allen E.P. i wsp.: .Periodontal soft tissue root coverage procedures: a consensus report from the AAP Regeneration Workshop. J. Periodontol., 2015, 86, 2, 52-55.
16. Tonetti M.S., Jepsen S.: Clinical efficacy of periodontal plastic surgery procedures: Consensus Report of Group 2 of the 10th European Workshop on Periodontology. J. Clin. Periodontol., 2014, 41, 15, 36-43.
17. Zucchelli G., De Sanctis M.: Treatment of multiple recession type defects in patients with aesthetic demands. J. Periodontol., 2000, 71, 1506-1514.
18. Zuhr O., Fickl S., Wachtel H. i wsp.: Covering of gingival recessions with a modified microsurgical tunnel technique: case report. Int. J. Periodontics Restorative Dent., 2007, 27, 457-463.
19. Tozum T.F., Keceli H.G., Guncu G.N. i wsp.: Treatment of gingival recession: comparison of two techniques of subepithelial connective tissue graft. J. Periodontol., 2005, 76, 1842-1848.
20. Salhi L., Lecloux G., Seidel L. i wsp.: Coronally advanced flap versus the pouch technique combined with a connective tissue graft to treat Miller’s class I gingival recession: a randomized controlled trial. J. Clin. Periodontol., 2014, 41, 387-495.
21. Azaripour A., Kissinger M., Farina V.S. i wsp.: Root coverage with connective tissue graft associated with coronally advanced flap or tunnel technique: randomized, double-blind, mono-centre clinical trial. J. Clin. Periodontol., 2016, 43, 1142-1150.
Bartłomiej Górski, Tomasz Kaczyński
Streszczenie
Recesje dziąsłowe są powszechnym problemem w praktyce klinicznej i mogą prowadzić do licznych powikłań estetycznych i stomatologicznych. Złotym standardem postępowania w przypadku mnogich recesji dziąsłowych jest technika dokoronowo przesuniętego płata z wykorzystaniem przeszczepu autologicznej podnabłonkowej tkanki łącznej. Jednak ze względu na potencjalne powikłania estetyczne związane z cięciami pionowymi oraz cięciami w obszarze brodawek alternatywę dla leczenia mnogich recesji dziąsłowych mogą stanowić techniki: kopertowa bądź tunelowa. Celem pracy było przedstawienie planowania leczenia mnogich recesji dziąsłowych oraz prezentacja przypadku pokrycia recesji z wykorzystaniem techniki tunelowej i przeszczepu podnabłonkowej tkanki łącznej.
Abstract
Multiple gingival recessions are common finding in clinical practice and can lead to many aesthetic and dental complications. Coronally advanced flap technique with autologous subepithelial connective tissue graft is considered as “the gold standard” in treatment of multiple gingival recessions. However, vertical releasing incisions and papillae incisions could lead to aesthetic compromises and thus tunnel technique could be alternative treatment method. The aim of this article was to discuss treatment planning of multiple gingival recessions and to present case of recession coverage with the use of tunnel technique and subepithelial connective tissue graft.
Hasła indeksowe: mnogie recesje dziąsłowe, technika tunelowa, przeszczep podnabłonkowej tkanki łącznej, leczenie ortodontyczne
Key words: multiple gingival recessions, tunnel technique, subepithelial connective tissue graft, orthodontic treatment
1. Wennstrom J.L.: Mucogingival Surgery. (w:) Lang N.P., Karring T., editors. Proceedings of the 1st European Workshop on Periodontology. Quintessence , London 1994, 193-209.
2. Serino G., Wennström J.L., Lindhe J., Eneroth L.: The prevalence and distribution of gingival recession in subjects with a high standard of oral hygiene. J. Clin. Periodontol., 1994, 21, 57-63.
3. Yoneyama T., Okamoto H., Lindhe J. i wsp.: Probing depth, attachment loss and gingival recession. J Clin Periodontol; 1988; 15; 581–91.
4. Kassab M.M., Cohen R.E.: The etiology and prevalence of gingival recession. J. Am. Dent. Assoc.,2003; 134; 220-5
5. Gillam D., Chesters R., Attrill D. i wsp.: Dentine hypersensitivity – guidelines for the management of a common oral health problem. Dentistry Update, 2013, 40, 514-516, 518-520, 523-524.
6. Wennström J.L., Lindhe J., Sinclair F. i wsp.: Some periodontal tissue reactions to orthodontic tooth movement in monkeys. J. Clin. Periodontol.,1987, 14, 121-129.
7. Joss-Vassalli I., Grebenstein C., Topouzelis N. i wsp.: Orthodontic therapy and gingival recession: a systematic review. Orthod. Craniofac. Res., 2010, 13, 127-141.
8. Johal A., Katsaros C., Kiliaridis S. i wsp.: State of the science on controversial topics: orthodontic therapy and gingival recession (a report of the Angle Society of Europe 2013 meeting). Progress in Orthodontics, 2013, 14, 16.
9. Chambrone L., Sukekava F., Araújo M.G.: Root coverage procedures for the treatment of localised recession-type defects. Cochrane Database Syst. Rev., 2009, 15, 2, CD007161.
10. Chambrone L., Tatakis D.N.: Periodontal soft tissue root coverage procedures: a systematic review from the AAP Regeneration Workshop. J. Periodontol., 2015, 86, 2, 8-51.
11. Cairo F., Cortellini P., Tonetti M.: Coronally advanced flap with and without connective tissue graft for the treatment of single maxillaary gingival recession with loss of inter-dental attachment. A randomized controlled clinical trial. J. Clin. Periodontol., 2012, 39, 8, 760-768.
12. Aroca .S, Keglevich T., Nikolidakis D.: Treatment of Class III multiple gingival recessions: a randomized-clinical trial. J. Clin. Periodontol., 2010, 37, 88-97.
13. Nordland W.P., Tarnow D.P.: A classification system for loss of papillary height. J. Periodontol., 1998, 69, 10, 1124-1126.
14. Ozcelik O., Seydaoglu G., Haytac M.C.: An explorative study to develop a predicitive model based on avascular exposed root surface area for root coverage after a laterally positioned flap. J. Periodontol., 2015, 86, 356-366.
15. Tatakis D.N., Chambrone L., Allen E.P. i wsp.: .Periodontal soft tissue root coverage procedures: a consensus report from the AAP Regeneration Workshop. J. Periodontol., 2015, 86, 2, 52-55.
16. Tonetti M.S., Jepsen S.: Clinical efficacy of periodontal plastic surgery procedures: Consensus Report of Group 2 of the 10th European Workshop on Periodontology. J. Clin. Periodontol., 2014, 41, 15, 36-43.
17. Zucchelli G., De Sanctis M.: Treatment of multiple recession type defects in patients with aesthetic demands. J. Periodontol., 2000, 71, 1506-1514.
18. Zuhr O., Fickl S., Wachtel H. i wsp.: Covering of gingival recessions with a modified microsurgical tunnel technique: case report. Int. J. Periodontics Restorative Dent., 2007, 27, 457-463.
19. Tozum T.F., Keceli H.G., Guncu G.N. i wsp.: Treatment of gingival recession: comparison of two techniques of subepithelial connective tissue graft. J. Periodontol., 2005, 76, 1842-1848.
20. Salhi L., Lecloux G., Seidel L. i wsp.: Coronally advanced flap versus the pouch technique combined with a connective tissue graft to treat Miller’s class I gingival recession: a randomized controlled trial. J. Clin. Periodontol., 2014, 41, 387-495.
21. Azaripour A., Kissinger M., Farina V.S. i wsp.: Root coverage with connective tissue graft associated with coronally advanced flap or tunnel technique: randomized, double-blind, mono-centre clinical trial. J. Clin. Periodontol., 2016, 43, 1142-1150.
