Journal of Dental Rehabilitation and Applied Science (구강회복응용과학지)

Korean Academy of Stomatognathic Function and Occlusion (대한턱관절교합학회)
권호 표지
DOI QR코드

DOI QR Code

Laterally positioned flap using subepithelial connective tissue graft for iatrogenic gingival recession treatment

상피하결합조직 이식을 동반한 측방변위 판막술을 통한 의원성 치은퇴축 치료 증례보고

  • Lee, Sung-Jo (Department of Periodontology, College of Dentistry, Dankook University)
  • 이성조 (단국대학교 치과대학 치주과학교실)
  • Received : 2016.12.07
  • Accepted : 2016.12.17
  • Published : 2016.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Gingival recession could occur after orthodontic or endodontic treatment. This could influence not only functional and aesthetic problem, but also patient's treatment satisfaction. There are a lot of techniques for preventing gingival recession, but laterally positioned flap with subepithelial connective tissue graft could get definite advantages such as increase of keratinized gingival width and harmonious color match between graft tissue and surrounding tissue. Clinician should select a right patient case and diagnosis with clinical and radiography exam. In a surgical procedure, getting enough amounts of subepithelial connective tissue and flap coverage should be taken into consideration. The clinical outcomes in this case report shows laterally positioned flap with subepithelial connective tissue graft could be a treatment with predictive outcome.

치은퇴축의 원인 중 하나인 의원성 치은퇴축은 교정치료 또는 근관치료에 의하여 발생할 수 있다. 이는 기능적, 심미적 문제뿐만 아니라 치료에 대한 만족도도 낮출 수 있다. 이를 위한 치료 방법으로 다양한 술식이 존재하나, 상피하결합조직 이식을 동반한 측방변위판막술은 각화치은량의 증대, 치유된 치은의 수여부 연조직과의 조화로운 형태 및 색을 얻을 수 있는 장점이 있다. 술 전 임상적 및 방사선학적 검사를 통한 예지성 있는 적절한 증례 선택을 필요로 하며 술식에 있어 적합한 양의 상피하결합조직 획득과 판막의 피개량을 고려해야 한다. 본 증례보고의 두 가지 다른 원인의 의원성 치은퇴축의 치료 결과를 살펴보았을 때, 상피하결합조직 이식을 동반한 측방변위판막술은 의원성 치은퇴축의 치료법으로 우수한 결과를 나타내었으며, 1년 이상의 추적관찰시 높은 예지성을 보였다.

Keywords

References

  1. Hall WB. Present status of soft tissue grafting. J Periodontol 1977;48:587-97. https://doi.org/10.1902/jop.1977.48.9.587
  2. Melsen B, Allais D. Factors of importance for the development of dehiscences during labial movement of mandibular incisors: a retrospective study of adult orthodontic patients. Am J Orthod Dentofacial Orthop 2005;127:552-61. https://doi.org/10.1016/j.ajodo.2003.12.026
  3. Seltzer S, Sinai I, August D. Periodontal effects of root perforations before and during endodontic procedures. J Dent Res 1970;49:332-9. https://doi.org/10.1177/00220345700490022301
  4. Miller PD Jr. A classification of marginal tissue recession. Int J Periodontics Restorative Dent 1985;5:8-13.
  5. Grupe HE, Warren RF Jr. Repair of gingival defects by a sliding flap operation. J Periodontol 1956;27:92-5. https://doi.org/10.1902/jop.1956.27.2.92
  6. Grupe HE. Modified technique for the sliding flap operation. J Periodontol 1966;37:491-5. https://doi.org/10.1902/jop.1966.37.6.491
  7. Lee CT, Chang PC, Touchan N, Royzman D. Root coverage with a modified laterally positioned flap combined with a subepithelial connective tissue graft in advanced recession. J Periodontal Implant Sci 2014;44:300-6. https://doi.org/10.5051/jpis.2014.44.6.300
  8. Zucchelli G. Mucogingival esthetic surgery. 1st ed. Milano; Quintessenza Edizioni; 2013. p. 330-78.
  9. Jahnke PV, Sandifer JB, Gher ME, Gray JL, Richardson AC. Thick free gingival and connective tissue autografts for root coverage. J Periodontol 1993;64:315-22. https://doi.org/10.1902/jop.1993.64.4.315
  10. Carnio J, Neiva RF. Mineral trioxide aggregate and subepithelial connective tissue graft for treatment of iatrogenic gingival recession: long-term results. Int J Periodontics Restorative Dent 2014;34:71-7. https://doi.org/10.11607/prd.1674
  11. Jung UW, Kim CS, Choi SH, Kim S. Gingival coverage of iatrogenically denuded labial bone resulting from thermal trauma. Int J Periodontics Restorative Dent 2013;33:635-9. https://doi.org/10.11607/prd.1024
  12. Ruben MP. Rationale for the employment of laterally positioned flaps and free autogenous gingival grafts in periodontics (I). Quintessence Int Dent Dig 1978;9:57-61.
  13. Ruben MP. Rationale for the employment of laterally positioned flaps and free autogenous gingival grafts in periodontics (II). Quintessence Int Dent Dig 1978;9:53-7.
  14. Hall WB. Gingival augmentation/mucogingival surgery. In: Nevins M, Becker W, Kornman K. Proceedings of the World Workshop in Clinical Periodontics. Chicago; American Academy of Periodontology; 1989. VII 1-21.
  15. Santana RB, Furtado MB, Mattos CM, de Mello Fonseca E, Dibart S. Clinical evaluation of singlestage advanced versus rotated flaps in the treatment of gingival recessions. J Periodontol 2010;81:485-92. https://doi.org/10.1902/jop.2010.090237
  16. Zucchelli G, Cesari C, Amore C, Montebugnoli L, De Sanctis M. Laterally moved, coronally advanced flap: a modified surgical approach for isolated recession-type defects. J Periodontol 2004;75:1734-41. https://doi.org/10.1902/jop.2004.75.12.1734
  17. Zuhr O, Baumer D, Hurzeler M. The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: critical elements in design and execution. J Clin Periodontol 2014;41 suppl 15:S123-42. https://doi.org/10.1111/jcpe.12185
  18. Yotnuengnit P, Promsudthi A, Teparat T, Laohapand P, Yuwaprecha W. Relative connective tissue graft size affects root coverage treatment outcome in the envelope procedure. J Periodontol 2004;75:886-92. https://doi.org/10.1902/jop.2004.75.6.886
  19. Langer B, Langer L. Subepithelial connective tissue graft technique for root coverage. J Periodontol 1985;56:715-20. https://doi.org/10.1902/jop.1985.56.12.715
  20. Miller PD Jr. Root coverage with the free gingival graft. Factors associated with incomplete coverage. J Periodontol 1987;58:674-81. https://doi.org/10.1902/jop.1987.58.10.674