Less Invasive Vestibule Access Tunneling with Platelet-rich Fibrin Membrane for the Treatment of Gingival Recession

Abstract

Aim:The aim of this study was to introduce the less invasive vestibule access tunneling in combination with platelet-rich fibrin (PRF) membrane for gingival recession treatment. Materials and methods: Seven subjects with Miller's class I or II buccal gingival recession were selected for this study. All subjects were treated with mucogingival surgery using the less invasive vestibule access tunneling in combination with PRF membrane. Clinical examination performed on each subject and the height of gingival recession was recorded preoperatively (baseline), and at 1 and 3 months postoperatively. The data were statistically analyzed using analysis of variance (ANOVA) with post hoc Tukey's LSD test to determine the significant difference between groups. Statistical significance level was set at 0.05. Results: The results showed that there were significant differences in recession height between baseline and both 1 month and 3 months postoperatively (p < 0.05). Nevertheless, there was no significant difference between 1 and 3 months postoperatively (p > 0.05). All patients reported satisfactory esthetic results both at 1 and 3 months postoperatively. Conclusion: Mucogingival surgery using the less invasive vestibule access tunneling in combination with PRF membrane for gingival recession treatment provided optimal root coverage. Clinical significance: This article introduces a new tunnel technique in combination with PRF membrane for gingival recession treatment. Previous studies tried to make access using the tunnel technique performed through gingival sulcus. In this study, the access is performed through the vestibule region. Access from the vestibule can minimize the damage of gingival margin integrity, especially in patients with thin gingival biotype.

Root coverage with platelet-rich fibrin or connective tissue graft: a split-mouth randomized trial

“…Therefore, this technique ensures a premature esthetic result and satisfactory healing because adequate blood supply is necessary to maintain the stability of the gingival attachment to the root surface. 39 Skierska et al 40 reported satisfactory values for RC (93.31%) and CRC (87.43%) after 2 years of follow-up using the TT associated with CTG in a retrospective study. However, limited gains in RC, CRC, KT width, and gingival thickness were observed on both sides in our study, with a reduction in these gains after 16 months.…”

Surgical Root Coverage of Miller’s Class III Using Free Gingival Autograft (A Case Report)

“…Mucogingival surgery is a procedure that can be used to repair gingival recession; this surgery focuses mostly on improving the appearance and functionality of the patient's mouth. In addition to increasing the zone of attached gingiva, maintaining the normal shape of the soft tissue, and providing enough gingival thickness with normal color, mucogingival surgery can cover exposed root surfaces up to the CEJ [8], [9]. There are four basic techniques for root coverage therapy:…”

“…An internal bevel incision is used during the tunneling procedure from above the gingival margin in the recessionprone area. The interdental papillae were then affected by extending a supraperiosteal partial thickness flap with strong dissection 3-5 mm laterally and apically to the recession area [8]. The gingival profile makes it challenging to regulate mechanical instrumentation throughout the tunneling technique and to appropriately detach the junctional epithelium from its attachment to the root surface.…”

“…Gingival fiber is crucial to root coverage therapy. The gingival margin is securely held to the tooth by gingival fiber, which strengthens and stabilizes it [8], [13]. Tunneling through the gingival sulcus, specifically in circular and semicircular gingival fiber incisions, can affect the integrity of the gingival fiber, and trauma to these gingival fibers results in unsatisfactory repair [8].…”