Clinical parameters, histological analysis, and laser Doppler flowmetry of different subepithelial connective tissue grafts

Abstract

Subepithelial connective tissue graft (SCTG) presents favorable outcomes. However, the harvesting technique can influence the anatomical and histological composition of the SCTG. Within the limitations of a case report, the behavior of SCTGs removed by two techniques was evaluated bilaterally in one patient using double blade scalpel (DBS) and de-epithelialized graft (DE). Clinical parameters, laser Doppler flowmetry (LDF) and histological analysis were assessed. Complete root coverage was observed bilaterally, as well as improvement in width and thickness of keratinized tissue 2 years postoperatively. The LDF analysis demonstrated better revascularization in the DBS recipient area compared to DE. The histological evaluation showed differences in tissue composition and organization of collagen fibers. Similar clinical outcomes were observed bilaterally, nevertheless greater morbidity and aesthetic was reported in the DE harvesting area.

Clinical and patient‐centered outcomes using two types of subepithelial connective tissue grafts: A split‐mouth randomized clinical trial

“…On the other hand, DBS graft is generally deeply removed from palatal area, resulting in a less dense connective tissue, disorganized collagen fibers and superior volume of adipose/glandular tissue (submucosa) 15,20–22 . In a recent publication, 23 clinical parameters, laser Doppler flowmetry (LDF) and histological analysis were used to evaluate the behavior of SCTGs removed by DBS and DE graft. After 2 years postoperatively, root coverage and improvement in width and thickness of keratinized tissue were observed for both techniques.…”

Análise do tratamento de recessões gengivais múltiplas com enxerto de tecido conjuntivo subepitelial removido de área palatina com predomínio de lâmina própria e com predomínio de submucosa

“…Both techniques proved to be efficient for root coverage in multiple adjacent gingival recessions, but with lower postoperative morbidity for the BLD group, which is an important criterion to be considered in the decision-making process to choose the SCTG removal technique. (MILLER, 1993;ZUCCHELLI et al, 2015;CAIRO, 2017;EUSTACHIO et al, 2018). A recessão gengival é uma condição que afeta mais da metade dos indivíduos (51,6%), sendo sua prevalência, extensão e severidade correlacionadas com a idade , 1980;LANGER;LANGER, 1985;RAETZKE, 1985, NELSON, 1987HARRIS, 1992;ALLEN, 1994, BRUNO, 1994.…”

“…A recessão gengival é uma condição que afeta mais da metade dos indivíduos (51,6%), sendo sua prevalência, extensão e severidade correlacionadas com a idade , 1980;LANGER;LANGER, 1985;RAETZKE, 1985, NELSON, 1987HARRIS, 1992;ALLEN, 1994, BRUNO, 1994. O ETCS, associado ao deslize coronal do retalho, é atualmente considerado o padrão ouro no recobrimento de superfícies radiculares em recessões gengivais classe I e II de Miller (CHAMBRONE, 2008;ZUCCHELLI et al, 2010;BERTL et al, 2015EUSTACHIO et al, 2018. No entanto, existem poucos estudos clínicos randomizados comparando os resultados obtidos a partir de diferentes tipos de ETCS.…”

“…Independente da técnica utilizada, o sítio de escolha para remoção do ETCS precisa fornecer quantidade adequada de tecido, evitando riscos ao paciente e com menor morbidade pós-operatória (ZUCCHELLI et al, 2010;ZUHR;HURZELER, 2014). Além da variação em sua geometria, os ETCS removidos de diferentes áreas do palato variam também em sua composição histológica (HARRIS, 2003;ZUHR et al, 2014;BERTL et al, 2015;EUSTACHIO et al, 2018). Presume-se que essas diferenças possam influenciar não somente na estabilidade do volume do enxerto, mas também no processo fisiológico de revascularização do ETCS (ZUHR; HURZELER, 2014).…”