DOI QR코드

DOI QR Code

Reconstruction of Interdental papilla through connective tissue graft with orthodontic treatment: A Clinical Case Report

교정치료를 동반한 CTG를 통한 치간유두 재생

  • Received : 2020.08.25
  • Accepted : 2020.10.19
  • Published : 2020.11.24

Abstract

Regeneration of interdental papilla damaged by periodontal disease is a very challenging task. So far, many dentists have devised and introduced great surgical methods. Comparing the pros and cons of the methods introduced so far, I came up with the best way to regenerate interdental papilla. Temporarily creating space between narrow interdental papilla, which cannot be solved by periodontal surgery alone, was a great help for connective tissue graft(CTG). The CTG was performed using a microblade, and only one vertical incision was performed off the gingival margin, and the graft was performed by inserting the grafts through here. Along with the orthodontic treatment, the area between the narrow interdental papilla was widened to make it easier for the CTG was carried out. After a period of maintenance, I was able to gather the teeth again with orthodontic force and regenerate the interdental papilla. I named this method ELSA (Enlargement of space-Labial graft-Squeezing-for Augmentation of papilla) technique.

치주질환으로 손상된 치간유두의 재생은 아주 도전적인 과제이다. 지금까지 많은 치과의사들이 훌륭한 수술적인 방법을 고안하여 소개하였다. 지금까지 소개된 술식들을 순서대로 비교해보고 장단점을 비교해 치간유두를 재생을 위한 최적의 방법을 고안해보았다. 치주수술만으로 해결하기 어려운 좁은 치간유두 사이의 공간을 부분교정치료를 통하여 공간을 일시적으로 만들어 주는 것이 치은이식을 위해 큰 도움이 되었다. 치은이식은 마이크로 블레이드를 이용하여 박리를 시행하고 치은경계부에서 떨어진 수직절개를 하나만 시행해 여기를 통해 추가적인 박리와 이식편을 넣어서 치은이식을 시행하였다. 이렇게 교정치료를 동반하여 좁은 치간유두 사이의 폭을 벌려서 치은이식이 더 용이한 상태로 만들어 치은이식을 진행하고, 치은이 성숙한 뒤 교정력으로 다시 치아사이를 모아주는 술식(ELSA technique)을 통해 치간유두 재생을 할 수 있었다.

Keywords

References

  1. Surgical reconstruction of the interdental papilla: case report. Beagle. Int J Periodontics Restorative Dent. 1992 Mar/ Apr;12(2):145-151.
  2. Progress in gingival papilla reconstruction. Han TJ, Takei HH. Periodontol 2000. 1996 Jun;11:65-8. doi: 10.1111/j.1600-0757.1996.tb00184.x.
  3. Surgical Reconstruction of the Interdental Papilla. Azzi/Etienne/Carranza. Int J Periodontics Restorative Dent. 1998 Sep/Oct;18(5):467-473
  4. Reconstruction of the interdental papilla with an underlying subepithelial connective tissue graft: technical considerations and case reports. Carranza N, Zogbi C. Int J Periodontics Restorative Dent. 2011 Sep-Oct;31(5):e45-50.
  5. Minimally invasive treatment of maxillary anterior gingival recession defects by vestibular incision subperiosteal tunnel access and platelet-derived growth factor BB. Zadeh HH. Int J Periodontics Restorative Dent. 2011 Nov-Dec;31(6):653-60.
  6. Clinical evaluation of papilla reconstruction using subepithelial connective tissue graft. Kaushik A, Pk P, Jhamb K, Chopra D, Chaurasia VR, Masamatti VS, Dk S, Babaji P. J Clin Diagn Res. 2014 Sep;8(9):ZC77-81. doi: 10.7860/ JCDR/2014/9458.4881. Epub 2014 Sep 20.
  7. Interproximal Tunneling with a Customized Connective Tissue Graft: A Microsurgical Technique for Interdental Papilla Reconstruction. Feuillet D, Keller JF, Agossa K. Int J Periodontics Restorative Dent. 2018 Nov/Dec;38(6):833-839. doi: 10.11607/prd.3549.
  8. The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: critical elements in design and execution. Zuhr O, Baumer D, Hurzeler M. J Clin Periodontol. 2014 Apr;41 Suppl 15:S123-42. doi: 10.1111/jcpe.12185.
  9. Changes in the vertical position of interdental papillae and interseptal bone following the approximation of anterior teeth. Kim YK, Kwon EY, Cho YJ, Lee JY, Kim SJ, Choi J. Int J Periodontics Restorative Dent. 2014 MarApr;34(2):219-24. doi: 10.11607/prd.1852.