2018, Number 1
<< Back Next >>
Rev Odont Mex 2018; 22 (1)
Treatment of multiple Miller class I and III gingival recessions by means of sub-epithelial connective tissue graft and tunnel technique
Lino AV, González EIZ, Martínez HR, Hurtado SA
Language: Spanish
References: 15
Page: 46-50
PDF size: 244.15 Kb.
ABSTRACT
Introduction: Gingival recession can be associated to periodontal disease or muco-gingival conditions causing hypersensitivity, root caries and esthetic problems. A combination of the tunneling technique with sub-epithelial connective tissue graft can be considered an option for multiple gingival recession treatment.
Case presentation: A 38 year old female patient who informed of suffering hypersensitivity in upper teeth (13, 14, 22, 23, 24), exhibiting gingival recession. Periodontal evaluation revealed Miller class I and III gingival recessions in quadrants I and II. Periodontal diagnosis was healthy periodontium. In order to achieve root coverage, placement of sub-epithelial connective tissue graft with tunneling was planned. This represents a suitable procedure in cases when interdental papillae are wide, moreover, it constitutes a high predictability technique in order to achieve root coverage. In the present case, it was decided to initiate treatment on the second quadrant since it lodged sites with greater dental hypersensitivity, to be followed a month later by treatment on the first quadrant.
Conclusions: This applied technique allowed for 100% elimination of tooth hypersensitivity, only considering a disadvantage the double surgical site of the donor site. It is important to mention that, in addition to achieving improvement in tooth hypersensitivity, esthetic appearance was improved.
REFERENCES
Niklaus PL, Lindhe J. Clinical periodontology and implant dentistry. 6a ed. Wiley Blackwell. 2015, p. 1002.
Chaparro A, De la Fuente M, Albers D, Hernandez D, Villalobos AM, Gaedechens D et al. Root coverage of multiple Miller Class I and II recession defects using acellular dermal matrix and tunneling technique in maxilla and mandible: a 1-year report. Int J Periodontics Restorative Dent. 2015; 35 (5): 639-645.
Singh J, Bharti V. Treatment of multiple gingival recessions adopting modified tunnel subepithelial connective tissue graft technique. Indian J Dent Res. 2014, 25 (6): 816-820.
Pini-Prato G, Magnani C, Zaheer F, Rotundo R, Buti J. Influence of inter-dental tissues and root surface condition on complete root coverage following treatment of gingival recessions: a 1-year retrospective study. J Clin Periodontol. 2015; 42 (6): 567-574.
Mitrea M, Rusu A, Calin D. Palatal connective tissue grafting through tunnel technique in anterior mandible: a case report. Revista Română de Anatomie Functionala si Clinica, Macro si Microscopica si de Antropologie. 2014; 13 (4): 540-547. 8p.
Nart J, Valles C. Subepithelial connective tissue graft in combination with a tunnel technique for the treatment of Miller class II and III gingival recessions in mandibular incisors: clinical and esthetic results. Int J Periodontics Restorative Dent. 2016; 36 (4): 591-598.
Zucchelli G, Stefanini M, Ganz S, Mazzotti C, Mounssif I, Mazzotti M. Coronally advanced flap with different designs in the treatment of gingival recession: a comparative controlled randomized clinical trial. Int J Periodontics Restorative Dent. 2016; 36 (3): 319-327.
Dani S, Dhage A, Gundannavar. The pouch and tunnel technique for management of multiple gingival recession defects. J Indian Soc of Periodontol. 2014; 18 (6): 776-780.
Allen EP. Subpapillary continuous sling suturing method for soft tissue grafting with the tunneling technique. Int J Periodontics Restorative Dent. 2010; 30 (5): 479-485.
Pini-Prato G, Magnani C, Zaheer F, Buti J, Rotundo R. Critical evaluation of complete root coverage as a successful endpoint of treatment for gingival recessions. Int J Periodontics Restorative Dent. 2015; 35: 655-663.
Deliberador TM, Santos FR, Bosco AF, Furlaneto FA, Messora MR, Giovanini AF et al. Simultaneous application of combination of three surgical techniques for treatment of gingival recession: a case report. Bull Tokyo Dent Coll. 2010; 51 (4): 201-205.
Mahn DH. Use of the tunnel technique and an acellular dermal matrix in the treatment of multiple adjacent teeth with gingival recession in the esthetic zone. Int J Periodontics Restorative Dent. 2010; 30 (6): 593-599.
Modarressi M, Wang HL. Tunneling procedure for root coverage using acellular dermal matrix: a case series. Int J Periodontics Restorative Dent. 2009; 29 (4): 395-403.
Pini-Prato G, Magnani C, Zaheer F, Rotundo R, Buti J. Influence of inter-dental tissues and root surface condition on complete root coverage following treatment of gingival recessions: a 1-year retrospective study. J Clin Periodontol. 2015; 42 (6): 567-574.
Lops D, Gobbato L, Nart J, Guazzo R, Ho DK, Bressan E. Evaluation of root coverage with and without connective tissue graft for the treatment of single maxillary gingival recession using an image analysis system: a randomized controlled clinical trial. Int J Periodontics Restorative Dent. 2015; 35 (2): 247-254.