title: Clinical evaluation of expanded mesh connective tissue graft in the treatment for multiple adjacent gingival recessions in the esthetic zone.
abstract: BACKGROUND
  Multiple approaches have been used to replace lost, damaged or diseased gingival tissues. The connective tissue graft (CTG) procedure is the golden standard method for root coverage. Although multiple sites often need grafting, the palatal mucosa supplies only a limited area of grafting material. To overcome this limitation, expanded mesh graft provides a method whereby a graft can be stretched to cover a large area. The aim of this study was to evaluate the effectiveness and the predictability of expanded mesh CTG (e-MCTG) in the treatment of adjacent multiple gingival recessions.
  
  
  METHODS
  Sixteen patients aged 20-50 years contributed to 55 sites, each site falling into at least three adjacent Miller's Class 1 or Class 2 gingival recession. The CTG obtained from the palatal mucosa was expanded to cover the recipient bed, which was 1.5 times larger than the graft. Clinical measurements were recorded at baseline and 3 months, 12 months postoperatively.
  
  
  RESULTS
  A mean coverage of 1.96 mm ± 0.66 mm and 2.22 mm ± 0.68 mm was obtained at the end of 3(rd) and 12(th) month, respectively. Twelve months after surgery a statistically significant increase in CAL (2.2 mm ± 0.68 mm, P < 0.001) and increasing WKT (1.75 ± 0.78, P < 0.001) were obtained. In 80% of the treated sites, 100% root coverage was achieved (mean 93.5%).
  
  
  CONCLUSIONS
  The results of this study demonstrated that multiple adjacent recessions were treated by using e-MCTG technique can be applied and highly predictable root coverage can be achieved.
authors: Department of Periodontics, Chettinad Dental College and Research Institute, Kelambakkam, India.
authors: M
authors: M
authors: Shanmugam
authors: Department of Periodontics, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India.
authors: B
authors: B
authors: Shivakumar
authors: Department of Periodontics, Chettinad Dental College and Research Institute, Kelambakkam, India.
authors: B
authors: B
authors: Meenapriya
authors: Department of Periodontics, Chettinad Dental College and Research Institute, Kelambakkam, India.
authors: V
authors: V
authors: Anitha
authors: Department of Periodontics, Chettinad Dental College and Research Institute, Kelambakkam, India.
authors: B
authors: B
authors: Ashwath
keywords: Expanded mesh connective tissue graft; gingival recession; root coverage; subepithelial connective tissue graft