Combined guided tissue regeneration, root conditioning, and fibrin-fibronectin system application in the treatment of gingival recession. A 15-case report.
This paper describes a surgical technique to achieve root coverage in deep, wide gingival recessions using a root isolation procedure with ePTFE membrane, combined with tetracycline conditioning of the root surface and fibrin-fibronectin sealing system application. The technique was used on 15 patients with isolated mucogingival defects 4 to 6 mm deep. A large trapezium-shaped flap was raised 3 to 4 mm apical to the margin of the bone dehiscence. The root surface was thoroughly scaled by hand and rotating instruments. Tetracycline HCl solution (100 mg/ml) was topically applied for 4 minutes. Expanded polytetrafluoroethylene (ePTFE) membrane was adapted at least 1 mm coronal to the CEJ and retained in position by sling sutures. A film of fibrin-fibronectin sealing system was injected between the membrane and the root surface. The flap was sutured coronally and the membrane removed 6 weeks later. The patients were reevaluated 6 months after the reentry procedure. The mean recession depth decreased from 4.7 mm initially to 1.1 mm at the final postoperative appointment. This represents a mean root coverage of 77.4%. Mean probing depth reduction was 0.9 mm and the mean width of keratinized tissue increased from 1.8 mm preoperatively to 2.9 mm 6 months after surgery. These findings show that the treatment of buccal gingival recession using guided tissue regeneration procedure plus tetracycline root demineralization and fibrin-fibronectin glue application results in a consistent and predictable improvement of mucogingival defects.
Department of Periodontology, School of Dentistry, University of Ferrara, Italy.
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Trombelli
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Schincaglia
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Checchi
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Calura
D000328:Adult; D003238:Connective Tissue / Q000502:physiology; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005889:Gingival Recession / Q000601:surgery*; D016557:Guided Tissue Regeneration, Periodontal; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D016745:Root Planing; D013752:Tetracycline / Q000494:pharmacology / Q000627:therapeutic use; D014092:Tooth Root / Q000187:drug effects; D014945:Wound Healing
D015718:Fibrin Tissue Adhesive; D008567:Membranes, Artificial; D011138:Polytetrafluoroethylene; D013752:Tetracycline