Comparative Clinical Evaluation of Semilunar Coronally Positioned Flap Alone and Semilunar Coronally Positioned Flap in Conjunction With Free Gingival Graft for Root Coverage
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 20
- 主要终点
- Width of Keratinized Tissue
研究概览
简要总结
Background and Objective: Gingival recession accounts for apical migration of the gingival margin resulting in exposure of the cementoenamel junction (CEJ) and root surface. It is a matter of concern for both patients and dental professionals, especially when exposure of the root surface is linked to deterioration in esthetic appearance and increase in dentinal hypersensitivity which leads to improvements in various surgical techniques that have been used to correct labial gingival recession defects. The present study thus was aimed to evaluate and compare the results of Semilunar Coronally Positioned Flap alone and Semilunar Coronally Positioned Flap in Conjunction with Free Gingival Graft for treatment of Miller Class I and II gingival recession defects in maxillary anterior teeth.
Materials and Method: A total of 20 bilateral Miller's class I and II gingival recession sites in systemically healthy subjects, 20-45 years of age were recruited for this study. Recession sites were divided and randomly allocated to either of the two groups SCPF+FGG (test group) and SCPF (control group) with 10 sites per group to be treated with semilunar coronally positioned flap with free gingival graft technique for SCPF+FGG group and semilunar coronally positioned flap technique alone for SCPF group. Longitudinal alterations during a follow-up period of 1, 3, 6 and 12 months in terms of Probing depth (PD), Recession width (RW), Recession height (RH), Width of keratinized tissue (WKT) and Clinical attachment level (CAL) were measured for both the groups and the values were statistically analysed.
详细描述
Gingival recession is a matter of concern for both patients and dental professionals, especially when exposure of the root surface is linked to deterioration in esthetic appearance and increase in dental hypersensitivity which provoked to propose various surgical techniques that have been used to correct labial/buccal gingival recession defects including periodontal plastic surgery. The goal of these surgical procedures is to correct the recession defects and remove or control the etiologic factors that result in mucogingival problems including free gingival autografts,laterally and coronally positioned flap, semilunar flap, guided tissue regeneration(GTR), subepithelial connective tissue graft (SCTG) and combination of procedures.
The selection of surgical technique depends on several factors including the anatomy of the defect site, size of recession defect, presence or absence of keratinized tissue adjacent to the defect, width and height of the interdental soft tissue and depth of the vestibule or the presence of frenula. It also depends on the objective of the treatment outcome which varies in maxilla and in mandible. In maxilla the desired outcome is aesthetics where as in case of mandible it is the mucogingival problems with restoration of normal function. Because of the existing controversies about using different techniques of root coverage and their disadvantages, there are only few documented reports about an esthetic outcome which is important in maxilla that can be gained through increased width of keratinized tissue.
The semilunar coronally positioned flap (SCPF) procedure introduced by Tarnow for treatment of gingival recessions is confined to the maxillary arch with esthetic outcome but no attempt is made to increase the width of keratinized tissueor thickness of gingival tissue. On the other hand, free gingival autograft (FGG) increases the width of keratinized tissue or thickness of gingiva predictably but may result in compromised color match due to lighter color of the graft. Thus simultaneous use of SCPF and FGG was performed to combine both desirable outcomes.
As there are no documented reports about comparative clinical evaluation of SCPF and simultaneous use of SCPF and FGG for covering the exposed root surface in Miller's class I and II gingival recession, an attempt is made to evaluate the results of simultaneous use of SCPF and FGG for covering the exposed root surface and its comparison with SCPF alone in the present study. Thus the aim of the present study is to compare and evaluate the results of using semilunar coronally positioned flap alone for root coverage with a combination technique of semilunar coronally positioned flap along with free gingival graft for root coverage and to assess the results of a combination technique of semilunar coronally positioned flap along with free gingival graft for root coverage. The goal of treatment is to improve aesthetic outcomes with gain in the keratinised tissue levels and clinical attachment level in addition to possible root coverage in maxillary anteriors.
Study Design:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 20 Years 至 45 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Bilateral Miller Class I and II gingival recessions in maxillary anterior teeth
排除标准
- •systemic conditions known to interfere with periodontal healing
- •history of addiction or drinking alcohol
- •Systemic or local bone diseases
- •Pregnancy and lactating females
- •using anticoagulant or immune suppressor drugs
- •the patients who are unable to maintain oral hygiene
- •presence of Type II and V caries and
结局指标
主要结局
Width of Keratinized Tissue
时间窗: 12 months
measured from most apical part of gingival recession to the mucogingival junction
Recession Height
时间窗: 12 months
measured from cemento enamel junction to the most apical part of gingival margin
次要结局
- Probing Depth(12 months)
- Clinical Attachment Level(12 months)
- Recession Width(12 months)
研究者
RAGA BINDU
Post Graduate
Kamineni Institute of Dental Sciences