Lectura 7.pdf

Sctg sutured at the level of the cej figure 4 the

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SCTG sutured at the level of the CEJ. Figure 4. The partial-thickness flap was coronally advanced and sutured as coronal as possible. Figure 5. Clinical view 6 months post-surgery. Figure 6. Preoperative view of a mandibular MRTD involving three teeth. Figure 7. Partial-thickness flap elevated. J Periodontol • May 2006 Chambrone, Chambrone 913
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whereas complete root coverage was achieved in 20 of the 28 MRTD sites (71%). Our findings are similar to those obtained by Allen 22 (84% and 61%); Zabalegui et al. 23 (92% and 67%); Zucchelli and De Sanctis 25 (97% and 88%), To ¨zum and Dini 28 (95% and 92%), and C x etiner et al. 29 (96% and 80%), respectively. In this study some inherent considerations should be discussed. First, three of the previously published studies included only maxillary areas, 23,25,28 whereas in the present paper, we also included mandibular sites, where our worst results were obtained. To our knowledge, there are no studies focusing on the re- sults of the treatment of an MRTD of maxillary and mandibular defects separately. Differences between mandibular and maxillary recession defect outcomes in terms of all clinical parameters were statistically significant except for PD ( P = 0.126) (Table 4). These outcomes may be linked to several conditions, such as the depth of the vestibular fornix, flap tensions, flap thickness, and mucogingival phenotypes. 11,29,31 Bouchard et al. 31 observed that an excessive coronal positioning of the mucogingival junction as a conse- quence of a CAF can burst the wound during healing in an area of shallow vestibular depth. Furthermore, C x etiner et al. 29 suggested that the SCTG should not be completely covered when the initial height of KT ispoorandtherearemorethanthreeadjacentdefects, in an attempt to achieve complete root coverage and improve the amount of KT. In our 28 patients, the SCTG was covered as much as possible by the CAF, even in areas where the initial KT was absent, with a final 6-month statistically significant increase. Second, the present study included only non- smokers. It has been shown that the number of ciga- rettes smoked daily is an important issue. Smoking 10 cigarettes per day is strongly associated with per- iodontal disease. 32 Thus, cigarette smoking may affect the short-term outcome of root coverageproce- dures and should be carefully considered when plan- ning a PPS procedure. 33,34 Third, all treated root surfaces were conditioned with tetracycline HCl. With respect to root condition- ing, the dental literature seems controversial. Con- trolled clinical studies have suggested that there is no significant clinical benefit of root conditioning in conjunction with root coverage procedures. 17,35 On the other hand, demineralization of exposed root sur- facesbycitricacid,tetracyclineHClsolution,orEDTA during root coverage procedures have been used for root conditioning to enhance the degree of new con- nective tissue attachment to denuded root surfaces Figure 8.
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  • Fall '19
  • Gingiva, Periodontitis, SCTG

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