Critical Evaluation of Complete Root Coverage as a Successful Endpoint of Treatment for Gingival Recessions

Pini‐Prato, Giovanpaolo; Magnani, Cristina; Zaheer, Faizan; Buti, Jacopo; Rotundo, Roberto

doi:10.11607/prd.2400

Cited by 12 publications

(8 citation statements)

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“…The extent of gingival recession, i.e., recession depth, is evaluated before and after treatment and represents one of the most important measures determining treatment outcome [1]. Recession depth is a measure used to quantify treatment success in terms of percentage of root coverage and defects with complete root coverage, enabling comparison between different treatment techniques [1,2]. Therefore, the accuracy of recession depth measurements is critical for diagnosis, optimal treatment planning, and outcome evaluation.…”

Section: Introductionmentioning

confidence: 99%

The precision of gingival recession measurements is increased by an automated curvature analysis method

2021

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Background The extent of gingival recession represents one of the most important measures determining outcome of periodontal plastic surgery. The accurate measurements are, thus, critical for optimal treatment planning and outcome evaluation. Present study aimed to introduce automated curvature-based digital gingival recession measurements, evaluate the agreement and reliability of manual measurements, and identify sources of manual variability. Methods Measurement of gingival recessions was performed manually by three examiners and automatically using curvature analysis on representative cross-sections (n = 60). Cemento-enamel junction (CEJ) and gingival margin (GM) measurement points selection was the only variable. Agreement and reliability of measurements were analysed using intra- and inter-examiner correlations and Bland–Altman plots. Measurement point selection variability was evaluated with manual point distance deviation from an automatic point. The effect of curvature on manual point selection was evaluated with scatter plots. Results Bland–Altman plots revealed a high variability of examiner’s recession measurements indicated by high 95% limits of agreement range of approximately 1 mm and several outliers beyond the limits of agreement. CEJ point selection was the main source of examiner’s variability due to smaller curvature values than GM, i.e., median values of − 0.98 mm− 1 and − 4.39 mm− 1, respectively, indicating straighter profile for CEJ point. Scatter plots revealed inverse relationship between curvature and examiner deviation for CEJ point, indicating a threshold curvature value around 1 mm− 1. Conclusions Automated curvature-based approach increases the precision of recession measurements by reproducible measurement point selection. Proposed approach allows evaluation of teeth with indistinguishable CEJ that could be not be included in the previous studies.

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Section: Introductionmentioning

confidence: 99%

The precision of gingival recession measurements is increased by an automated curvature analysis method

2021

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“…Although the presence of a larger avascular area could limit the RC obtained, 14,27 our results could be explained by the technique itself, which was designed for the treatment of these specific recessions, allowing an increase in the vascularization to the underlying CTG. Anchoring the LPF on the de‐epithelialized papillae allows its coronal displacement, covering and overlapping the CEJ to increase the probability of achieving a greater RC 28,29 . Also, starting the preparation of the mucoperiosteal tunnel from apical, close to the mucogingival junction and extending it towards coronal, would decrease the risk of perforation, especially in thin phenotypes, thus avoiding compromising the vascularization of the recipient bed.…”

Section: Discussionmentioning

confidence: 99%

Treatment of deep single RT2 and RT3 antero‐mandibular gingival recessions with a combination of surgical techniques: A case series study

Fernández‐Jiménez,

García‐De‐La‐Fuente,

Marichalar‐Mendia

et al. 2023

J Esthet Restor Dent

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ObjectiveTo evaluate root coverage (RC) in deep single antero‐mandibular RT2 and RT3 gingival recessions (GR) and to investigate the influence of several factors in RC.Materials and MethodsFifteen single antero‐mandibular GR with a minimum depth of 3 mm were consecutively treated with a new one‐stage technique (laterally positioned flap with a tunnel access and a connective tissue graft). At baseline and at 12‐month follow‐up, the percentage of mean root coverage (%MRC), the recession reduction (RecRed), complete root coverage (CRC) and the gain of keratinized tissue width (KTW) were assessed. Descriptive, intergroup comparative and correlation analyses were performed.ResultsAt 12 months, a %MRC of 77.29 ± 21.48% with a mean RecRed of 4.10 ± 1.51 mm was achieved. The %MRC was 84.71 ± 21.08% in RT2, and 62.43 ± 14.17% in RT3. The mean gain of KTW was 2.10 ± 0.89 mm, with a mean gain of 2.0 ± 1.03 mm for RT2 and 2.3 ± 0.57 mm for RT3. CRC was observed in six cases, all of them being RT2. A positive association was found between the %MRC and the initial position of the tooth and of both papillae.ConclusionsThis technique might be a valuable approach for the treatment of deep single antero‐mandibular RT2 and RT3 recessions, even in malpositioned teeth.Clinical SignificanceA combination of different surgical techniques could provide greater vascularization to the CTG especially in malpositioned teeth in sextant V with a large avascular area to be covered.

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“…The treatment for gingival recession is considered completely successful when root coverage is associated with a gingival margin and a crevice probing depth that is coronal to the cementoenamel junction [30], as presented in this case report with 5-year follow-up.…”

Section: Discussionmentioning

confidence: 99%

Coverage Root after Removing Peripheral Ossifying Fibroma: 5-Year Follow-Up Case Report

Henriques

Okajima

Nunes

et al. 2016

Case Reports in Dentistry

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When lesions in soft tissue reach the gingival margin, they can produce aesthetic defects during its permanence and after its removal. Periodontal plastic surgery allows the correction of the gingival contour using different techniques. This paper is a case report of a peripheral ossifying fibroma removal in the interproximal area of teeth 21 and 22 in addition to root coverage of the affected area through two surgical phases: keratinized gingival tissue augmentation surgery with free gingival graft concurrent with removal of the lesion and, in a second stage, root coverage by performing coronally advanced flap technique with a follow-up of five years. The initial results achieved, which were root coverage of 100% after 6 months, promoted an adequate gingival contour and prevented the development of a mucogingival defect or a root exposure with its functional and aesthetic consequences. After five years, the results showed long term success of the techniques, where the margin remained stable with complete root coverage and tissues were stable and harmonic in color.

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Critical Evaluation of Complete Root Coverage as a Successful Endpoint of Treatment for Gingival Recessions

Cited by 12 publications

References 0 publications

The precision of gingival recession measurements is increased by an automated curvature analysis method

The precision of gingival recession measurements is increased by an automated curvature analysis method

Treatment of deep single RT2 and RT3 antero‐mandibular gingival recessions with a combination of surgical techniques: A case series study

Coverage Root after Removing Peripheral Ossifying Fibroma: 5-Year Follow-Up Case Report

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