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Markus B Hurzeler - One of the best experts on this subject based on the ideXlab platform.
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tunnel technique with connective Tissue Graft versus coronally advanced flap with enamel matrix derivative for root coverage a rct using 3d digital measuring methods part i clinical and patient centred outcomes
Journal of Clinical Periodontology, 2014Co-Authors: Otto Zuhr, Stephan F Rebele, David Schneider, Rony E Jung, Markus B HurzelerAbstract:Aim The aim of this randomized clinical trial (RCT) was to introduce 3D digital measuring methods for evaluating the outcomes after surgical root coverage (RC) and to assess the clinical performance of the tunnel technique with subepithelial connective Tissue Graft (TUN) versus the coronally advanced flap (CAF) with enamel matrix derivative in the treatment of shallow localized gingival recession defects. Material and Methods Twenty-four patients contributed a total of 47 Miller class I or II recessions for scientific evaluation. Clinical outcomes were evaluated at 6 and 12 months. Precise study models gained at baseline and follow-up examinations were optically scanned and virtually superimposed for digital evaluation of clinical outcome measures including percentage of RC and complete root coverage (CRC). Patient-centred outcomes were evaluated with questionnaires. Final aesthetic outcomes were assessed using the root coverage esthetic score (RES). Results At 12 months, RC was 98.4% for TUN-treated and 71.8% for CAF-treated defects (p = 0.0004). CRC was observed in 78.6% (TUN) and 21.4% (CAF) of the cases (p = 0.0070). Results for patient-centred outcomes were equivalent for both groups but evaluation of the final aesthetic outcomes using the RES revealed a significant difference (9.06 versus 6.92, p = 0.0034) in favour of TUN. Conclusions TUN resulted in significantly better clinical outcomes compared with CAF. The new measuring method provided high accuracy and unforeseen precision in the evaluation of treatment outcomes after surgical RC.
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tunnel technique with connective Tissue Graft versus coronally advanced flap with enamel matrix derivative for root coverage a rct using 3d digital measuring methods part ii volumetric studies on healing dynamics and gingival dimensions
Journal of Clinical Periodontology, 2014Co-Authors: Stephan F Rebele, Otto Zuhr, David Schneider, Rony E Jung, Markus B HurzelerAbstract:AIM: The aim of this randomized clinical trial (RCT) was to compare the clinical performance of the tunnel technique with subepithelial connective Tissue Graft (TUN) versus a coronally advanced flap with enamel matrix derivative (CAF) in the treatment of gingival recession defects. The use of innovative 3D digital measuring methods allowed to study healing dynamics at connective Tissue (CT)-Grafted sites and to evaluate the influence of the thickness of the root covering soft Tissues on the outcome of surgical root coverage. MATERIAL & METHODS: Twenty-four patients contributed a total of 47 Miller class I or II recessions for scientific evaluation. Precise study models collected at baseline and follow-up examinations were optically scanned and virtually superimposed for digital evaluation of clinical outcome measures including mean marginal soft Tissue thickness (THK). Healing dynamics were measured in a defined region of interest at CT-Grafted sites where volume differences between time points were calculated. RESULTS: At 12 months, recession reduction as well as mean root coverage were significantly better at CT-Grafted sites treated in the TUN group (1.94 mm and 98.4% respectively) compared to the non-augmented sites of the CAF group (1.17 mm and 71.8% respectively) and statistical analysis revealed a positive correlation of THK (1.63 mm TUN versus 0.91 mm CAF, p < 0.0001) to both these variables. Soft Tissue healing following surgical root coverage with CT-Grafting was mainly accomplished after 6 months, with around two-thirds of the augmented volume being maintained after 12 months. CONCLUSIONS: The TUN resulted in thicker gingiva and better clinical outcomes compared to CAF. Increased gingival thickness was associated with better surgical outcomes in terms of recession reduction and root coverage.
Pierpaolo Cortellini - One of the best experts on this subject based on the ideXlab platform.
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coronally advanced flap with and without connective Tissue Graft for the treatment of single maxillary gingival recession with loss of inter dental attachment a randomized controlled clinical trial
Journal of Clinical Periodontology, 2012Co-Authors: Francesco Cairo, Michele Nieri, Pierpaolo Cortellini, Maurizio S Tonetti, Jana Mervelt, Sandro Cincinelli, Giovan Paolo PinipratoAbstract:Background The aim of this randomized clinical trial (RCT) was to evaluate the adjunctive benefit of Connective Tissue Graft (CTG) to Coronally Advanced Flap (CAF) for the treatment of gingival recession associated with inter-dental clinical attachment loss equal or smaller to the buccal attachment loss (RT2). Material and Methods A total of 29 patients with one recession were enrolled; 15 patients were randomly assigned to CAF+CTG while 14 to CAF alone. Measurements were performed by a blind and calibrated examiner. Outcome measures included complete root coverage (CRC), recession reduction (RecRed), Root coverage Esthetic Score (RES), intra-operative and post-operative morbidity, and root sensitivity. Results After 6 months, CAF+CTG resulted in better outcomes in terms of CRC (adjusted OR = 15.51, p = 0.0325) than CAF alone. CRC was observed in >80% of the cases treated with CAF+CTG when the baseline amount of inter-dental CAL was ≤3 mm. No difference was detected in term of RecRed. CAF+CTG was associated with longer surgical-time (p < 0.0001), higher number of days with post-operative morbidity (p = 0.0222) and the need for a greater number of analgesics (p = 0.0178) than CAF alone. No difference for final RES score was detected (p = 0.1612). Conclusion Both treatments can provide CRC in single gingival recession with inter-dental CAL loss. The application of CTG under CAF resulted in predictable CRC when inter-dental CAL was ≤3 mm.
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coronally advanced flap versus connective Tissue Graft in the treatment of multiple gingival recessions a split mouth study with a 5 year follow up
Journal of Clinical Periodontology, 2010Co-Authors: Giovan Paolo Piniprato, Francesco Cairo, Michele Nieri, Debora Franceschi, Roberto Rotundo, Pierpaolo CortelliniAbstract:Pini-Prato GP, Cairo F, Nieri M, Franceschi D, Rotundo R, Cortellini P. Coronally advanced flap versus connective Tissue Graft in the treatment of multiple gingival recessions: a split-mouth study with a 5-year follow-up. J Clin Periodontol 2010; 37: 644–650. doi: 10.1111/j.1600-051X.2010.01559.x Abstract Aim: The aim of this long-term study was to compare the clinical outcomes of coronally advanced flap (CAF) alone versus coronally advanced flap plus connective Tissue Graft (CAF+CTG) in the treatment of multiple gingival recessions using a split-mouth design over 5 years of follow-up. Materials and Methods: A total of 13 patients (mean age 31.4 years) showing multiple bilateral gingival recessions were treated. On one side, CAF+CTG was used, while in the contra-lateral side, a CAF alone was applied. Clinical outcomes were evaluated at the 6-month, 1-year and 5-year follow-ups. Results: A total of 93 Miller class I, II and III gingival recessions were treated. In the CAF+CTG-treated sites, the baseline gingival recession was 3.6 ± 1.3 mm, while in the CAF-treated sites, it was 2.9 ± 1.3 mm (p=0.0034). No difference in terms of the number of sites with complete root coverage (CRC) was reported (OR=0.49, p=0.1772) at the 6-month follow-up. At the 5-year follow-up, CAF+CTG-treated sites showed a higher percentage of sites with CRC (52%) than CAF-treated sites (35%) (OR=3.94; p=0.0239). An apical relapse of the gingival margin in CAF-treated sites was observed while a coronal improvement of the margin was noted in CAF+CTG-treated sites between the 6-month and the 5-year follow-ups. Conclusions: CAF+CTG provided better CRC than CAF alone in the treatment of multiple gingival recessions at the 5-year follow-up.
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does placement of a connective Tissue Graft improve the outcomes of coronally advanced flap for coverage of single gingival recessions in upper anterior teeth a multi centre randomized double blind clinical trial
Journal of Clinical Periodontology, 2009Co-Authors: Pierpaolo Cortellini, Michele Nieri, Debora Franceschi, Roberto Rotundo, Maurizio S Tonetti, Carlo Baldi, Luca Francetti, Giulio Rasperini, Antonella Labriola, Giovanpaolo Pini PratoAbstract:Aims: This parallel-group, multi-centre, double-blind, randomized-controlled clinical trial was undertaken to compare the clinical outcomes and patient morbidity of coronally advanced flap (CAF) alone or in combination with a connective Tissue Graft (CAF1CTG) in single Miller Class I and II gingival recessions. Material and Methods: Three centres enrolled 85 patients with one recession each. Surgery was performed elevating a pedicle flap; 42 sites randomly received a Graft under the flap. Measurements were taken by blind and calibrated examiners. Outcome measures included recession reduction, complete root coverage (CRC), intra-operative and post-operative morbidity, dentine sensitivity, and side effects. Results: No differences were noted in the intra-operative and post-operative patientrelated variables between the two groups. Surgical time was significantly shorter in the CAF group. Recession reduction was not statistically different between the two groups, even though a model showed a tendency towards improved outcomes in sites treated with CAF1CTG (adjusted difference 0.33mm, 95% CI 5 0.06 to 0.72, p 50.1002). Significantly greater probability of CRC was observed after CAF1CTG (adjusted OR 55.09, 95% CI 51.69‐17.57, p 50.0033). Dentine hypersensitivity improved in both the groups. Conclusions: Both treatments were effective in providing a significant reduction of the baseline recession and dentine hypersensitivity, with only limited intra-operative and post-operative morbidity and side effects. Adjunctive application of a CTG under a CAF increased the probability of achieving CRC in maxillary Miller Class I and II defects.
Giuseppe Perinetti - One of the best experts on this subject based on the ideXlab platform.
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subpedicle acellular dermal matrix Graft and autogenous connective Tissue Graft in the treatment of gingival recessions a comparative 1 year clinical study
Journal of Periodontology, 2002Co-Authors: M Paolantonio, Marco Dolci, Paola Esposito, Domenico Darchivio, Luca Lisanti, Alfonso Di Luccio, Giuseppe PerinettiAbstract:Background: Many surgical techniques have been proposed for the correction of dental root exposition. Among these, bilaminar techniques (BTs) have been reported as offering the best results in terms of root coverage (RC). However, BTs require a second surgical site to harvest the Graft, with discomfort for the patient. The use of an acellular dermal matrix (ADM) avoids the need for a donor site. The aim of this study was to compare the clinical results of 2 BTs by autogenous connective Tissue (CT) or ADM. Methods: In 30 systemically healthy, non-smoking patients aged 34.5 ± 5.2 years, who showed no periodontal pockets >4 mm after a hygienic phase, a Miller's class I or II gingival recession was treated for root coverage. All patients underwent a BT: in 15 patients, an autogenous connective Tissue Graft was employed (CT group); in the other 15 subjects, ADM was used as a subepithelial Graft (ADM group). Prior to and 1 year after surgical treatment, the following clinical parameters were recorded: gingival ...
Mauro Pedrine Santamaria - One of the best experts on this subject based on the ideXlab platform.
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resin composite plus connective Tissue Graft to treat single maxillary gingival recession associated with non carious cervical lesion randomized clinical trial
Journal of Clinical Periodontology, 2016Co-Authors: Mauro Pedrine Santamaria, Felipe Lucas Da Silva Neves, Camila Augusto Silveira, Maria Aparecida Neves Jardini, Lucas Araujo Queiroz, Ingrid Fernandes Mathias, Eduardo Bresciani, Enilson Antonio SallumAbstract:Aim To evaluate clinically, the aesthetics and the patient-centred parameters after the treatment of gingival recession associated with non-carious cervical lesion by connective Tissue Graft alone or combined with a nanofilled resin composite restoration. Methods Thirty-six patients presenting one Miller Class I or II gingival recessions and B+ tooth cervical defect were included. The defects were treated by either connective Tissue Graft (CTG: control group; n = 18) or connective Tissue Graft plus resin composite restoration (CTG+RC: test group; n = 18). Results The mean percentage of defect coverage was 82.16 ± 16.1% for CTG and 73.84 ± 19.2% for CTG+RC after 1 year (p > 0.05). Both groups presented statistically significant improvements in two aesthetics evaluations. The professional evaluation (MRES) was 7.44 ± 2.3 for the CTG group and 7.52 ± 2.27 for CTG+RC after 1 year, with no significant difference between the groups. The two groups presented significant reduction of dentin sensitivity (DS), it decreased from 94.4% of the sites to 44.4% in the CTG group and from 88.8% to 5.5% in the CTG+RC group. Conclusions CTG or CTG+RC can successfully treat gingival recession associated with B+ non-carious cervical lesion, but less sensitivity may be expected with the combined approach (NCT02423473).
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Comparison of two power densities on the healing of palatal wounds after connective Tissue Graft removal: randomized clinical trial
Lasers in Medical Science, 2016Co-Authors: Felipe Lucas Da Silva Neves, Camila Augusto Silveira, Stephanie Botti Fernandes Dias, Milton Santamaria Júnior, Andrea Carvalho De Marco, Warley David Kerbauy, Antonio Braulino De Melo Filho, Maria Aparecida Neves Jardini, Mauro Pedrine SantamariaAbstract:Connective Tissue Graft (CTG), which is considered to be among the best techniques for treating gingival recession, has presented stable long-term results. However, this technique causes morbidity and discomfort in the palatine region due to Graft removal at that site. A previous study reports that photobiomodulation (PBM) using a dosage of 15 J/cm(2) may improve wound healing and the patient's postoperative comfort. However, no other studies in the literature provide the best application dosage or comparisons between protocols for this purpose. The aim of this study is to compare two power densities of PBM on the wound-healing process of the donor palatine area after CTG removal. In this study, 51 patients presenting buccal gingival recession were randomized into one of the following groups: group 1: CTG procedure for root coverage and PBM application at the donor site using a 60 J/cm(2) dose; group 2: CTG and PBM application using a 30 J/cm(2) dose; or group 3: CTG and sham application. The evaluated parameters were the wound remaining area (WRA), scar and Tissue colorimetry (TC), Tissue thickness (TT), and postoperative discomfort (D), evaluated at baseline and 7, 14, 45, 60, and 90 days after surgery. Group 1 presented statistically significant smaller wounds at day 7 (p > 0.05). None of the patients presented scars at the operated area, and all of the patients reported mild discomfort, with low consumption of analgesic pills. We concluded that the protocol of 60 J/cm(2) provided faster wound healing 7 days after removing the connective Tissue Graft for root coverage. TRIAL REGISTRATION: ClinicalTrial.org (NCT02580357) https://clinicaltrials.gov/ct2/show/NCT02580357 .
Marcio Fernando De Moraes Grisi - One of the best experts on this subject based on the ideXlab platform.
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comparative 6 month clinical study of a subepithelial connective Tissue Graft and acellular dermal matrix Graft for the treatment of gingival recession
Journal of Periodontology, 2001Co-Authors: Arthur B Novaes, Daniela C Grisi, Gustavo Otoboni Molina, Sergio Luis Scombatti De Souza, Mario Taba, Marcio Fernando De Moraes GrisiAbstract:Background: Different techniques have been proposed for the treatment of gingival recessions. This study compared the clinical results of gingival recession treatment using a subepithelial connective Tissue Graft and an acellular dermal matrix alloGraft. Methods: Nine patients with bilateral Miller Class I or II gingival recessions were selected. A total of 30 recessions were treated and randomly assigned to the test group and the contralateral recession to the control group. In the control group, the exposed root surfaces were treated by the placement of a connective Tissue Graft in combination with a coronally positioned flap; in the test group, an acellular dermal matrix alloGraft was used as a substitute for palatal donor Tissue. Probing depth, clinical attachment level, gingival recession, and width of keratinized Tissue were measured 2 weeks prior to surgery and 3 and 6 months postsurgery. Results: There were no statistically significant differences between the test group and the control group in te...
