Combined guided tissue regeneration, root conditioning, and fibrin-fibronectin system application in the treatment of gingival recession. A 15-case report
The aim of this paper was to look at the effectiveness of GTR with e-PTFE membrane and tetracycline and fibrin-fibronectin system application for the treatment of gingival recession. The examiners took 15 patients, ages 23-57 years old, with a buccal recession 2 4 mm with no bone or soft tissue loss in the interdental area. They were given oral hygiene instructions along with scaling and root planing. Recession, pocket depth and probing attachment loss, and keratinized tissue were also measured. The surgical technique consisted of horizontal incisions mesial and distal to the defect of the level of the CEJ and 0.5 mm away from the gingival margin of adjacent teeth. Oblique releasing incisions were made into alveolar mucosa. A full-thickness flap was raised and then, 3-4 mm apical to the bone dehiscence, a partial thickness flap was done. The root was prepared with hand instruments and burnished 100 mg/ml tetracycline for four minutes. An e-PTFE membrane was placed 1 mm coronal to the CEJ and was sutured with a sling suture. A 2-3 ml film of fibrin/fibronectin glue was placed between the membrane and root surface. The interdental papillae was de-epithelialized and sutured as coronally as possible without dressing. The membrane was removed in six weeks. The patients were monitored every month for six months and reevaluated. The mean gain was 3.6 mm from 4.7 initial recession to 1.1 mm at the final postoperative appointment. This represents a mean root coverage of 77.4%. The width of keratinized tissue also increased from 1.8 mm preoperatively to 2.9 mm six months after. These results show that the treatment of buccal recession using a guided tissue regeneration procedure plus tetracycline root conditioning and fibrin-fibronectin glue application results in improvement of mucogingival defects . [M . C . R. ]
Trombelli L., G. Schincaglia, L. Checchi and G. Calura, J Periodont, 65:796, 1994