Combined Guided Tissue Regeneration, Root Conditioning, and Fibrin‐Fibronectin System Application in the Treatment of Gingival Recession. A 15‐Case Report

Abstract

This paper describes a surgical technique to achieve root coverage in deep, wide gingival recessions using a root isolation procedure with ePTFE membrane, combined with tetracycline conditioning of the root surface and fibrin-fibronectin sealing system application. The technique was used on 15 patients with isolated mucogingival defects 4 to 6 mm deep. A large trapezium-shaped flap was raised 3 to 4 mm apical to the margin of the bone dehiscence. The root surface was thoroughly scaled by hand and rotating instruments. Tetracycline HCl solution (100 mg/ml) was topically applied for 4 minutes. Expanded polytetrafluoroethylene (ePTFE) membrane was adapted at least 1 mm coronal to the CEJ and retained in position by sling sutures. A film of fibrin-fibronectin sealing system was injected between the membrane and the root surface. The flap was sutured coronally and the membrane removed 6 weeks later. The patients were reevaluated 6 months after the reentry procedure. The mean recession depth decreased from 4.7 mm initially to 1.1 mm at the final postoperative appointment. This represents a mean root coverage of 77.4%. Mean probing depth reduction was 0.9 mm and the mean width of keratinized tissue increased from 1.8 mm preoperatively to 2.9 mm 6 months after surgery. These findings show that the treatment of buccal gingival recession using guided tissue regeneration procedure plus tetracycline root demineralization and fibrin-fibronectin glue application results in a consistent and predictable improvement of mucogingival defects.

Periodontal plastic surgery for treatment of localized gingival recessions: a systematic review

“…Jepsen et al (2000), Rachlin et al (1996), Roccuzzo & Buser (1996), Shieh et al (1997), Tinti et al (1992), Trombelli et al (1994), Trombelli et al (1998a), Zahedi et al (1998) (2000), Borghetti et al (1999), Matarasso et al (1998), , Tatakis & Trombelli (2000), Trombelli et al (1998b), Zucchelli et al (1998) Connective tissue graft 5 3.01…”

Evidence‐Based Mucogingival Therapy. Part 2: Ordinary and Individual Patient Data Meta‐Analyses of Surgical Treatment of Recession Using Complete Root Coverage as the Outcome Variable

“…Thus, the analysis was conducted on 4 groups of studies (or arms thereof): CAF: 10; 5-14 EFGG: 9; 15-23 CTG: 23; 24-42 and GTR: 23 (Table 1). [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] The 65 studies covered a total of 1,822 treated recessions: CAF: 388; EFGG: 330; CTG: 664; and GTR: 440.…”

Platelet‐Rich Plasma and Connective Tissue Grafts in the Treatment of Gingival Recessions: A Histometric Study in Dogs

“…Buccal gingival recessions in the anterior region represent one of the most important challenges for periodontists. A variety of surgical procedures have been described to achieve soft tissue coverage of exposed root surfaces, such as the laterally positioned flap, 3 coronally positioned flap, 4 free gingival graft, 5,6 subepithelial connective tissue graft (SCTG) with a coronally positioned flap, 7 and guided tissue regeneration 8–11 …”