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

Cortellini, Pierpaolo; Tonetti, Maurizio S.; Baldi, Carlo; Francetti, Luca; Rasperini, Giulio; Rotundo, Roberto; Nieri, Michele; Franceschi, Debora; Labriola, Antonella; Prato, Giovanpaolo Pini

doi:10.1111/j.1600-051x.2008.01346.x

Cited by 165 publications

(273 citation statements)

References 40 publications

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“…A meta-analysis of CPF and CTG revealed that the mean percentage of root coverage and mean percentage of patients with complete root coverage following CPF were 80% and 50%, respectively, while the corresponding values for CTG were 86% and 61%, respectively, indicating the superiority of CTG 10) . Cortellini et al 4) compared the clinical outcomes of CPF and CTG in single Miller Class I and II gingival recession in a multicenter, double-blind, randomized-controlled clinical trial and similarly concluded that CTG increased the probability of achieving complete root coverage.…”

Section: Discussionmentioning

confidence: 99%

Root Coverage Technique with Enamel Matrix Derivative

Moriyama

Matsumoto

Makiishi

2009

Bull. Tokyo Dent. Coll.

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Various periodontal plastic surgical techniques are employed in obtaining root coverage. Recently, the use of an enamel matrix derivative (EMD) has been reported in such treatment. We report 2 cases of root coverage surgery with a coronally positioned flap in combination with EMD (CPF‫ם‬EMD) and connective tissue graft in combination with EMD (CTG‫ם‬EMD). Case 1: The patient was a 25-year-old woman referred to Suidobashi Hospital, Tokyo Dental College for root coverage surgery on the lower right first premolar. Gingival recession was classified as Miller Class II, as no alveolar bone loss or loss of attachment was observed in the interdental area, although recession had progressed to the mucogingival junction. The patient was diagnosed with local gingival recession caused by excessive tooth brushing. Primary conservative treatment failed to reduce the gingival recession. Subsequently, root coverage surgery with CPF‫ם‬EMD was carried out. As observation at the 1-year follow-up revealed complete root coverage and no recurrence of root exposure or subjective symptoms, the postoperative course was considered to be favorable. Case 2: The patient was a 39-year-old woman referred to Suidobashi Hospital, Tokyo Dental College for root coverage surgery on the lower left canine. Gingival recession was classified as Miller Class II. Root coverage surgery with CTG‫ם‬EMD was carried out. As observation at the 2-month follow-up revealed complete root coverage and no recurrence of root exposure, the postoperative course was considered to be favorable. These 2 cases indicate the effectiveness of root coverage surgery with CPF‫ם‬EMD and CTG‫ם‬EMD.

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Section: Discussionmentioning

confidence: 99%

Root Coverage Technique with Enamel Matrix Derivative

Moriyama

Matsumoto

Makiishi

2009

Bull. Tokyo Dent. Coll.

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“…Several systematic reviews summarize the results, which may vary regarding complete root coverage (CRC), depending on the surgical technique applied (Roccuzzo et al 2002;Oates et al 2003;Clauser et al 2003;Pagliaro et al 2003;Cairo et al 2008;Chambrone et al 2009;Chambrone et al 2012;Cairo et al 2014). The best results regarding CRC have been reported for the combination of a coronally advanced flap with an underlying connective tissue graft (CTG) (Cortellini et al 2009). It may be speculated that the CTG, firmly sutured to the neighbouring periosteum or gingiva, may positively influence the mechanical properties of the wound and stabilize the mucosal flap by improving blood clot adhesion and maturation on the avascular dentinal surface.…”

Section: Accepted Articlementioning

confidence: 99%

Interposition of a connective tissue graft or a collagen matrix to enhance wound stability – an experimental study in dogs

Burkhardt

Magaz

Hämmerle

et al. 2016

J Clinic Periodontology

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AIM The aim of this study was to evaluate the role of a connective tissue graft (CTG) or a collagen matrix (CM) interpositioned between flaps and non-shedding hard surfaces on wound stability. MATERIAL AND METHODS Sixty bone dehiscence defects were prepared in five Beagle dogs. Three treatments were performed in 12 sites per dog: (1) repositioned flaps were sutured onto instrumented dentin surfaces (control), (2) repositioning of flaps with an interpositioned CTG and (3) repositioning of flaps with the application of a CM. To allow postoperative healing with n = 5 for 1, 3, 7 and 14 days before evaluation, the sutures were removed, incision lines retraced and tensile forces applied to the flaps. The minimum magnitude of forces required to detach the flaps from the wound bed was recorded. RESULTS After 1 week of healing, 6 N had to be applied to disrupt flaps from their wound bed in the CTG group. In the control group, a similar magnitude of resistance was achieved after 2 weeks (6.1 N). Flap resistance to tearing was highest in the CTG group (maximum 9.1 N) 2 weeks postoperatively. On the third postoperative day, the mean tearing forces of all groups differed significantly, displaying a 50% lower resistance to tearing in the CM compared to the CTG group. In comparison, flap resistance to tearing forces established earlier and in higher magnitude in sites with an interpositioned CTG than in flaps repositioned on dentin or CM. CONCLUSIONS Application of a CTG, sutured to a non-shedding hard surface, significantly increased flap resistance to tearing when applying disrupting forces compared to controls. A less pronounced effect was achieved by interpositioning of a CM. Accepted ArticleThis article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/jcpe.12526 This article is protected by copyright. All rights reserved.

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“…La mayoría de los tratamientos en las recesiones gingivales dan resultados predecibles en recesiones clase I y II de Miller con el uso de CDC por sí solo o con el uso de injertos. La literatura también reporta una amplia variación para el parámetro clínico de cubrimiento radicular, con rangos que van entre el 70 al 98% 1,2,3,8,12,14,15 . Es aquí donde la membrana de fibrina podría ser una opción interesante como injerto, debido a la gran cantidad de factores de crecimiento, que cumplirían un rol crucial en la regeneración tisular 6,8,14,13 .…”

Section: Bibliografía Discusiónunclassified

“…conclusión El presente caso clínico muestra que el uso de CDC+ITC en una recesión gingival tipo I de Miller resulta ser un tratamiento predecible y de primera elección para la cobertura radicular tanto en función como estética 1,2,3,11,12,14,15 , si se compara con un CDC+L-PRF. El uso de CDC+L-PRF es una técnica que muestra la ventaja de un menor dolor postoperatorio 7 , se evita la intervención de la zona donante y se obtienen valores clínicos aceptables, pero los resultados en nuestro caso clínico no fueron similares al sitio donde se usó un ITC.…”

Section: Bibliografía Discusiónunclassified