Healing response of human buccal gingival recession treated with expanded polytetrafluoroethylene membranes. A retrospective report
The aim of this study was to clinically evaluate the efficacy of surgical treatment of gingival recession based on guided tissue regeneration principles. Researchers also analyzed the influence of hard and soft tissue morphology of the mucogingival defects on clinical parameters. They took 24 patients, for a total of 24 buccal recessions that were at least 4 mm deep with no soft or hard tissue loss in the interdental area, and treated these with GTR procedure. The surgical procedure consisted of a trapezoidal flap with two oblique vertical incisions. The researchers did partial-thickness dissection to a level that would allow for coronal repositioning of the flap without tension. The root surfaces were planed with curets and rotating instruments. In 6 of 24 cases, the root surfaces were treated with saturated tetracycline solution, followed with a fibrin/fibronectin sealing system. This was then fitted with an e-PTFE membrane and positioned 1 mm above the cemento-enamel junction. Then 8 of 24 of the cases were treated in the same manner without the root-conditioning agents. Membranes were removed in six weeks, and professional cleanings were carried out every month for six months and every three months thereafter. Healing response was evaluated after 12 months. The results showed no significant differences between the two groups both preoperatively and postoperatively. At the reentry procedure, the mean membrane exposure was 2.4 mm. The deeper the baseline recession depth, the greater the newly formed tissue (NFT); and the wider the exposure of the membrane, the lower the newly formed tissue gain. Clinically, the greater the baseline recession depth and the NFT gain, the greater the reduction in recession depth. Recession width and membrane exposure were negatively related. Probing attachment level (PAL) gain had a direct proportion between baseline PAL and NFT gain. Keratinized tissue increased from 1.9 to 2.9 mm. The greater the NFT gain, the greater the keratinized tissue increase; and the narrower the baseline keratinized tissue, the greater the keratinized tissue gain. The average root coverage was 71.7%. The authors conclude that e-PTFE membrane can promote the resolution of deep and wide mucogingival defects. [M.C.R.]
Trombelli L., G. Schincaglia, C. Scapoli and G. Calura, J Periodont, 66:14,1995