Minimal invasiveness in gingival augmentation and root coverage procedures

Cairo, Francesco; Burkhardt, Rino

doi:10.1111/prd.12477

Cited by 5 publications

(2 citation statements)

References 147 publications

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“…Finally, the surgical technique we used did not adhere to the principles of minimally invasive periodontal plastic surgery, and this may have negatively influenced the esthetic results [52].…”

Section: Discussionmentioning

confidence: 99%

Treatment of Multiple RT1 Gingival Recessions Using a Coronally Advanced Flap Associated with L-PRF or Subgingival Connective Tissue Graft from Maxillary Tuberosity: A Randomized, Controlled Clinical Trial

Balice,

Paolantonio,

Serroni

et al. 2024

Dentistry Journal

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The goal of plastic periodontal surgery is to obtain complete root coverage, increasing gingival thickness (GT), a positive prognostic factor for gingival margin stability over time. The aim of this study was to compare the effectiveness of the Coronally Advanced Flap (CAF) in RT1 (GR; gingival recession with no loss of interproximal attachment) when associated with a connective tissue graft from the maxillary tuberosity (tCTG) or with leukocyte and platelet-rich fibrin (L-PRF) membranes in obtaining root coverage and increasing the thickness and width of the keratinized tissue, along with aesthetic improvement, taking into account a number of patient-related outcomes. Thirty patients with two adjacent RT1 GRs (GRs with no loss of interproximal attachment) were each treated using CAF associated with tCTG (15 patients) or L-PRF. The main outcome was a GT increase; secondary outcomes were keratinized tissue width (KT), gingival recession (GR), probing depth (PD), clinical attachment level (CAL), root coverage percentage (RC%), complete root coverage (CRC), and root coverage esthetic score (RES). Patient-reported outcomes were discomfort (D), dentine hypersensitivity (DH), patient-related esthetic score (PRES), and overall treatment satisfaction (OTS). After 12 months, clinical and patient-reported parameters did not show significant differences between groups, with the only exception being a GT gain, which was significantly greater in the CAF+tCTG group. Our results showed that both techniques were effective in treating RT1 GRs, with comparable patient-related outcomes. However, the use of tCTG produces significantly thicker tissue, covering the exposed root surface.

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Section: Discussionmentioning

confidence: 99%

Treatment of Multiple RT1 Gingival Recessions Using a Coronally Advanced Flap Associated with L-PRF or Subgingival Connective Tissue Graft from Maxillary Tuberosity: A Randomized, Controlled Clinical Trial

Balice,

Paolantonio,

Serroni

et al. 2024

Dentistry Journal

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“…To eliminate these negative results and minimize trauma to the surrounding tissues, it is recommended to use a minimally invasive method for ap preparation that can protect the underlying graft tissue and support rapid vascularization [51]. The concept of minimally invasive surgery encompasses all aspects of surgical techniques involving minimal wounds, minimal ap re ection, and gentle manipulation/handling of soft and hard tissues [52,53]. Various tunnelling techniques have been described to maintain recipient site aesthetics and prevent relapse of recession [54].…”

Section: Discussionmentioning

confidence: 99%

Innovative i-PRF semisurgical method for gingival augmentation and root coverage in thin periodontal phenotypes: A preliminary study

Alan

Ercan

Firatli

et al. 2023

Preprint

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Objectives The aim of this study was to evaluate the effect of injectable platelet-rich fibrin (i-PRF) on gingival thickness (GT) and gingival recession (GR) in individuals with thin periodontal phenotypes using a semisurgical approach.Materials and methods In this prospective study, i-PRF was applied via a semisurgical method to augment 53 tooth regions with thin periodontal phenotypes. i-PRF injection was applied to the relevant areas in 4 sessions at an interval of 10 days. GT, GR, keratinized tissue width and periodontal parameters were also recorded before treatment and at 6 months after the last injection.Results A statistically significant difference was observed in GT and GR values at the end of the study compared to baseline. Accordingly, an increase in GT was achieved in 92.5% of the areas treated with i-PRF, and the desired GT (0.8 mm) was achieved in 44.9% of these areas. In addition, significant reductions in the amount of recession were observed in 83.3% of the 12 GR areas (p = 0.005). Moreover, complete coverage was achieved in 60% of these regions.Conclusion With the new i-PRF semisurgical method, which we introduced in this first preliminary study, we showed that GT can be increased in tooth regions with thin gingiva and that areas of GR can be covered. Further comprehensive studies are needed to fully understand the role of i-PRF in enhancing angiogenesis and the histoconductive properties of this fully autogenous blood concentrate.Clinical relevance Classical periodontal plastic surgery applications cannot give predictable results in areas with thin periodontal phenotypes, especially in the case of bone dehiscence and fenestration. In some cases, undesirable progressive GR in these tooth regions also draws attention. With this new i-PRF semisurgical method, successful and predictable treatments can be applied in tooth areas with thin gingiva by increasing angiogenesis and taking advantage of the histoconductive properties of i-PRF.

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Effect of Coenzyme Q10 on early wound healing after recession coverage surgery with the modified coronally advanced tunnel technique and a connective tissue graft: A 6-month, triple-blinded, randomized, placebo-controlled pilot trial

Stähli,

De Ry,

Roccuzzo

et al. 2024

Clin Oral Invest

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Objectives Coenzyme Q10 (CoQ10) or ubiquinone is one of a cell’s most important electron carriers during oxidative phosphorylation and many other cellular processes. As a strong anti-oxidant with further anti-inflammatory effects CoQ10 is of potential therapeutical value. The aim of this randomized controlled clinical trial was to investigate the effect of topical CoQ10 on early wound healing after recession coverage surgery using the modified coronally advanced tunnel (MCAT) and palatal connective tissue graft (CTG). Materials and methods Thirty patients with buccal gingival recessions were evaluated after being randomly allocated to: 1) MCAT and CTG with topical application of a coenzyme Q10 spray for 21 days or 2) MCAT and CTG with placebo spray. Wound healing was evaluated by the early wound healing index (EHI). Patient-reported pain was analyzed by a 100-mm visual analogue scale (VAS) at day 2, 7, 14 and 21 post-surgically. Mean recession coverage, gain of keratinized tissue and esthetic outcomes were assessed at 6 months. Results EHI and pain scores showed no significant differences. Time to recovery defined as VAS<10 mm was shorter in the test group. Mean root coverage after 6 months was 84.62 ± 26.57% and 72.19 ± 26.30% for test and placebo, p=0.052. Complete root coverage was obtained in 9 (60%) test and in 2 (13.3%) placebo patients. Increase in keratinized tissue width and esthetical outcomes were similar for both groups. Conclusion CoQ10 had no significant effect on early wound healing and on mean root coverage after 6 months. Clinical relevance Early wound healing: in young healthy patients with no inflammatory oral conditions topical CoQ10 does not improve early healing.

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Minimal invasiveness in gingival augmentation and root coverage procedures

Cited by 5 publications

References 147 publications

Treatment of Multiple RT1 Gingival Recessions Using a Coronally Advanced Flap Associated with L-PRF or Subgingival Connective Tissue Graft from Maxillary Tuberosity: A Randomized, Controlled Clinical Trial

Treatment of Multiple RT1 Gingival Recessions Using a Coronally Advanced Flap Associated with L-PRF or Subgingival Connective Tissue Graft from Maxillary Tuberosity: A Randomized, Controlled Clinical Trial

Innovative i-PRF semisurgical method for gingival augmentation and root coverage in thin periodontal phenotypes: A preliminary study

Effect of Coenzyme Q10 on early wound healing after recession coverage surgery with the modified coronally advanced tunnel technique and a connective tissue graft: A 6-month, triple-blinded, randomized, placebo-controlled pilot trial

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