The free rotated papilla autograft: a new bilaminar grafting procedure for the coverage of multiple shallow gingival recessions.
The aim of this clinical pilot study is to evaluate the possibility and from a statistical point of view, the predictability of a new mucogingival technique. The purpose of this surgical procedure is to cover the exposed buccal root surface with less than 5 mm clinical probing attachment loss either in corono-apical or mesio-distal aspects. This surgical procedure is particularly indicated in either single or multiple gingival recessions with perfectly preserved mesial and distal interproximal osseous crests, and with a papillary dimension not inferior to the defect which needs to be treated. A sharp incision is performed at a 90 degrees angle to the vestibule, following the mucogingival line. A sharp dissection is accomplished to create a partial thickness envelope flap on the underlying alveolar mucosa. The epithelium from the facial aspect of the papilla is debrided with a full thickness approach, the facial papillary tissue is removed from the underlying tissue bed. The papilla is then reversed in such a way that the base of the papilla is at the cemento-enamel junction (CEJ) and the apex is at the base of the gingival recession area. The papilla is then sutured in place and completely covered by a coronally displaced partial thickness flap. The results obtained either as root coverage, or as an aesthetic result, may be considered positive. This procedure has the decided advantage of a single surgical site, avoiding any palatal patient discomfort, good color compatibility with adjacent tissue, and healing by primary intention.
Tinti
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Department of Periodontology, University of Ferrara, Dental School, Italy.
Parma-Benfenati
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D000328:Adult; D003646:Debridement; D004210:Dissection; D004848:Epithelium / Q000601:surgery; D004955:Esthetics, Dental; D005069:Evaluation Studies as Topic; D005260:Female; D005544:Forecasting; D005881:Gingiva / Q000637:transplantation*; D005889:Gingival Recession / Q000601:surgery*; D005893:Gingivoplasty / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000601:surgery; D010149:Postoperative Pain / Q000517:prevention & control; D017622:Periodontal Attachment Loss / Q000601:surgery; D010858:Pigmentation; D010865:Pilot Projects; D013524:Surgical Flaps / Q000379:methods; D013536:Suture Techniques; D019237:Tooth Cervix; D014092:Tooth Root / Q000601:surgery; D014182:Transplantation, Autologous; D014945:Wound Healing