The Journal of the Korean dental association (대한치과의사협회지)

The Korean Dental Association (대한치과의사협회)
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Soft tissue volume changes following gingival grafting for labial gingival recession in the mandibular anterior area: a case report

  • Song, Young Woo (Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry) ;
  • Jung, Ui-Won (Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry) ;
  • Cha, Jae-Kook (Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry)
  • Received : 2019.07.04
  • Accepted : 2019.09.30
  • Published : 2019.12.31
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Abstract

This case report presents results for gingival recession coverage following gingival grafting and for gingival biotype enhancements by visualizing soft tissue volume changes using intraoral three-dimensional scanning. A 28 year old female patient with multiple gingival recessions and a 19 year old female patient with a single gingival recession on mandibular anterior area were treated. Root coverage was performed in both cases using autogenous subepithelial connective tissue harvested from palate. Intraoral 3D scan data were obatained presurgery and at 3 months, 1 year, and 2 years postsurgery. The recession areas were recovered successfully by subepithelial connective tissue graft combined with pedicle flap repositioning, and the patients showed neither further recurrence nor post-operative complication. Soft tissue biotype changes were identified by superimposing and analyzing scan data, revealing that gingival biotype was enhanced in both cases. These cases suggest that SCTG could be advantageous in terms of the gingival biotype enhancement, as well as gingival recession coverage, and intraoral 3D scanning might be suitable for assessing post-surgical gingival biotype change.

Keywords

Acknowledgement

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (Ministry of Science, ICT & Future Planning) (No. NRF-2017R1A2B2002537).

References

  1. Loe H, Anerud A, Boysen H. The natural history of periodontal disease in man: prevalence, severity, and extent of gingival recession. J Periodontol 1992;63(6):489-495 https://doi.org/10.1902/jop.1992.63.6.489
  2. Sangnes G, Gjermo P. Prevalence of oral soft and hard tissue lesions related to mechanical toothcleansing procedures. Community Dent Oral Epidemiol 1976;4(2):77-83 https://doi.org/10.1111/j.1600-0528.1976.tb01607.x
  3. Susin C, Haas AN, Oppermann RV, et al. Gingival recession: epidemiology and risk indicators in a representative urban Brazilian population. J Periodontol 2004;75(10):1377-1386 https://doi.org/10.1902/jop.2004.75.10.1377
  4. Miller PD, Jr. A classification of marginal tissue recession. Int J Periodontics Restorative Dent 1985;5(2):8-13
  5. Cairo F, Nieri M, Cincinelli S, et al. The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: an explorative and reliability study. J Clin Periodontol 2011;38(7):661-666 https://doi.org/10.1111/j.1600-051X.2011.01732.x
  6. Zucchelli G, Mounssif I. Periodontal plastic surgery. Periodontol 2000 2015;68(1):333-368 https://doi.org/10.1111/prd.12059
  7. Borghetti A, Gardella JP. Thick gingival autograft for the coverage of gingival recession: a clinical evaluation. Int J Periodontics Restorative Dent 1990;10(3):216-229
  8. 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(5):635-639 https://doi.org/10.11607/prd.1024
  9. Jung UW, Um YJ, Choi SH. Histologic observation of soft tissue acquired from maxillary tuberosity area for root coverage. J Periodontol 2008;79(5):934-940 https://doi.org/10.1902/jop.2008.070445
  10. Hwang D, Wang HL. Flap thickness as a predictor of root coverage: a systematic review. J Periodontol 2006;77(10):1625-1634 https://doi.org/10.1902/jop.2006.060107
  11. Memon S, Patel JR, Sethuraman R, et al. A comparative evaluation of the reliability of three methods of assessing gingival biotype in dentate subjects in different age groups: An in vivo study. J Indian Prosthodont Soc 2015;15(4):313-317 https://doi.org/10.4103/0972-4052.171830
  12. Zawawi KH, Al-Zahrani MS. Gingival biotype in relation to incisors' inclination and position. Saudi Med J 2014;35(11):1378-1383
  13. Pietruska M, Skurska A, Podlewski L, et al. Clinical evaluation of Miller class I and II recessions treatment with use of modified coronally advanced tunnel technique with either collagen matrix (CM) or subepithelial connective tissue graft (SCTG): a randomized clinical study. J Clin Periodontol 2018
  14. Gurlek O, Sonmez S, Guneri P, Nizam N. A novel soft tissue thickness measuring method using cone beam computed tomography. J Esthet Restor Dent 2018
  15. Thoma DS, Jung RE, Schneider D, et al. Soft tissue volume augmentation by the use of collagen-based matrices: a volumetric analysis. J Clin Periodontol 2010;37(7):659-666 https://doi.org/10.1111/j.1600-051X.2010.01581.x
  16. Sanz-Martin I, Sailer I, Hammerle CH, Thoma DS. Soft tissue stability and volumetric changes after 5 years in pontic sites with or without soft tissue grafting: a retrospective cohort study. Clin Oral Implants Res 2016;27(8):969-974 https://doi.org/10.1111/clr.12743
  17. Sanz Martin I, Benic GI, Hammerle CH, Thoma DS. Prospective randomized controlled clinical study comparing two dental implant types: volumetric soft tissue changes at 1 year of loading. Clin Oral Implants Res 2016;27(4):406-411 https://doi.org/10.1111/clr.12579
  18. Song YW, Kim S, Waller T, et al. Soft tissue substitutes to increase gingival thickness: Histologic and volumetric analyses in dogs. J Clin Periodontol 2019;46(1):96-104 https://doi.org/10.1111/jcpe.13034
  19. Zucchelli G, Mounssif I, Mazzotti C, et al. Does the dimension of the graft influence patient morbidity and root coverage outcomes? A randomized controlled clinical trial. J Clin Periodontol 2014;41(7):708-716 https://doi.org/10.1111/jcpe.12256
  20. Jepsen S, Caton JG, Albandar JM, et al. Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol 2018;45 Suppl 20:S219-s229 https://doi.org/10.1111/jcpe.12951
  21. Tarnow DP, Magner AW, Fletcher P. The effect of the distance from the contact point to the crest of bone on the presence or absence of the interproximal dental papilla. J Periodontol 1992;63(12):995-996 https://doi.org/10.1902/jop.1992.63.12.995
  22. Zeltner M, Jung RE, Hammerle CH, et al. Randomized controlled clinical study comparing a volume-stable collagen matrix to autogenous connective tissue grafts for soft tissue augmentation at implant sites: linear volumetric soft tissue changes up to 3 months. J Clin Periodontol 2017;44(4):446-453 https://doi.org/10.1111/jcpe.12697
  23. Azaripour A, Kissinger M, Farina VS, et al. Root coverage with connective tissue graft associated with coronally advanced flap or tunnel technique: a randomized, double-blind, mono-centre clinical trial. J Clin Periodontol 2016;43(12):1142-1150 https://doi.org/10.1111/jcpe.12627
  24. Akcali A, Schneider D, Unlu F, et al. Soft tissue augmentation of ridge defects in the maxillary anterior area using two different methods: a randomized controlled clinical trial. Clin Oral Implants Res 2015;26(6):688-695 https://doi.org/10.1111/clr.12368
  25. Stefanini M, Jepsen K, de Sanctis M, et al. Patient-reported outcomes and aesthetic evaluation of root coverage procedures: a 12-month follow-up of a randomized controlled clinical trial. J Clin Periodontol 2016;43(12):1132-1141 https://doi.org/10.1111/jcpe.12626
  26. Cairo F, Nieri M, Pagliaro U. Efficacy of periodontal plastic surgery procedures in the treatment of localized facial gingival recessions. A systematic review. J Clin Periodontol 2014;41 Suppl 15:S44-62 https://doi.org/10.1111/jcpe.12182
  27. Langer B, Langer L. Subepithelial connective tissue graft technique for root coverage. J Periodontol 1985;56(12):715-720 https://doi.org/10.1902/jop.1985.56.12.715
  28. Rasperini G, Acunzo R, Pellegrini G, et al. Predictor factors for long-term outcomes stability of coronally advanced flap with or without connective tissue graft in the treatment of single maxillary gingival recessions: 9 years results of a randomized controlled clinical trial. J Clin Periodontol 2018;45(9):1107-1117 https://doi.org/10.1111/jcpe.12932
  29. Pini Prato GP, Franceschi D, Cortellini P, Chambrone L. Long-term evaluation (20 years) of the outcomes of subepithelial connective tissue graft plus coronally advanced flap in the treatment of maxillary single recession-type defects. J Periodontol 2018;89(11):1290-1299 https://doi.org/10.1002/jper.17-0619