Newly forming bone graft: a novel surgical approach to the treatment of denuded roots

Abstract

Many techniques have been proposed for root coverage. However, none of them presents predictable results in deep and wide recessionsObjectiveThe aim of this case series report is to describe an alternative technique for root coverage at sites showing deep recessions and attachment loss >4 mm at buccal sites. Material and MethodsFour patients presenting deep recession defects at buccal sites (≥4 mm) were treated by the newly forming bone graft technique, which consists in the creation of an alveolar socket at edentulous ridge and transferring of granulation tissue present in this socket to the recession defect after 21 days. Clinical periodontal parameters, including recession depth (RD), probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), plaque index (PI) and keratinized gingiva width (KGW) were evaluated by a single examiner immediately before surgery and at 1, 3, 6 and 9 months postoperatively. ResultsAll cases showed reduction in RD and PD, along with CAL gain, although no increase in KGW could be observed. These findings suggest that the technique could favor periodontal regeneration along with root coverage, especially in areas showing deep recessions and attachment loss.

Osteogenic cells transfer improving root coverage: A randomized clinical trial

“…This technique was originally proposed to the treatment of periodontal infrabony defects, showing histologic evidence of periodontal regeneration in animals and clinical signs suggestive of periodontal regeneration in humans . The technique is based on the transfer of osteogenic cells, allowing the regeneration of lost periodontal tissues along with root coverage. This is particularly important at sites showing deep recession defects, in which soft tissue grafts show limited results …”

“…The NFBG‐based root coverage has been described in detail before . Bone defects (10 mm deep × 3 mm diameter approximately) were surgically created at the edentulous ridge with a diamond bur under irrigation 21 days before root coverage.…”

“…To overcome these problems, regenerative techniques were proposed to attain root coverage along with regeneration of lost periodontium, including guided tissue regeneration (GTR), bone substitutes, enamel derivative matrix, growth factors, and bioengineered matrix, also showing varying—although promising—results, depending on the technique. In this study, a regenerative technique named “newly forming bone graft” (NFBG), which consists in the transfer of immature osteogenic cells from healing sockets to the periodontal defects, was used to treat deep recession defects, since promising results were previously observed . The aim of this randomized prospective clinical trial is to compare the efficacy of this technique with SCTG in the treatment of Miller class I or II deep recessions.…”

Efeitos do PDGF-BB na taxa de proliferação e na adesão de células derivadas da granulação óssea a fragmentos radiculares

“…Mais recentemente, a técnica foi usada para o recobrimento de raízes apresentando recessões profundas e amplas, resultando em diminuição da profundidade de sondagem, ganho de inserção, diminuição do sangramento e recobrimento radicular semelhante àquele observado com o tratamento de recessões por meio da técnica de enxerto de tecido conjuntivo subepitelial (Ferraz 2009;Sant'Ana et al 2012). …”

“…Conforme previamente evidenciado em estudos histológico (Passanezi et al 1989) e clínicos (Passanezi et al 1989, Ferraz 2009Sant'Ana et al 2012;Ferraz 2013), a técnica do enxerto ósseo em neoformação (granulação óssea) resulta em regeneração dos tecidos periodontais, com formação de novo osso, cemento e ligamento (conforme evidenciado em cães), fechamento Dentro da metodologia empregada neste estudo, pode-se concluir que:…”