engleski

Treatment of deep cervical abrasions in multiple recession defects with connective tissue grafts - 1 year results

Fourteen non-smoking patients aged between 20-58 (32, 5±10, 54), 13 females and 1 male with 92 recession defects were enrolled for this study. After instructions in proper oral hygiene measures and achievement of full mouth plaque and bleedings scores of <20% the surgical treatment was scheduled. The overall base-line average depth of the recessions was 2, 74±1, 25mm, pocket depth 1, 11±0, 31mm and clinical attachment loss 3, 85±1, 28mm. The depth of the recessions ranged from 1 to 8. Flaps were raised according to the Zucchelli technique and connective tissue grafts were harvested from the palate with the trap-door approach. We did not grind and eliminate the abrasions and root concavities, but rather placed connective tissue grafts into the defects in order to prevent an internal collapse of the overlaying soft tissue flap. The connective tissue grafts were sutured using 5-0 or 6-0 prolene with cross mattress sutures going apically of the grafts through the periosteum and with a knot tied on the palatal or lingual surfaces of the teeth. This suture allowed for a close adaptation of the graft inside the abrasion defect and prevented its movement. Following a sharp incision into the vestibular lining mucosa a coronal advancement of the flap of at least 1-3mm over the CEJ was achieved. The flap was then sutured in the most coronal position using sling or single interrupted sutures with 5-0 prolene. One year after the procedures the mean recession depth had decreased to 0, 21±0, 46 and CAL of 1, 42±0, 63. Overall root coverage was 92% with 73 recession achieving complete root coverage (79%). The 55 sites with deep abrasion defects treated with connective tissue grafts had deeper average depths of 3, 23±1, 2mm and CAL of 4, 32±1, 25. One year later the mean recession depth was 0, 25±0, 47mm and CAL of 1, 45±0, 68mm with 92, 4% of mean root coverage. 41 recessions (75%) showed complete root coverage with one lower molar still having a 2mm recession and other 13 teeth having recession of 1mm or less.The use of a connective tissue grafts in deep cervical abrasions in multiple recession defects is very effective in correcting the defects and root coverage, eliminating greatly further hard tissue loss and restorative treatment.

gingival recession; mucogingival surgery; esthetics

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