Recession coverage using the modified coronally advanced tunnel and connective tissue graft with or without enamel matrix derivative: 5-year results of a randomised clinical trial

Stähli, Alexandra; Duong, H. Y.; Imber, Jean‐Claude; Roccuzzo, Andrea; Salvi, Giovanni E.; Katsaros, Christos; Ramseier, C. A.; Sculean, Anton

doi:10.1007/s00784-022-04691-8

Cited by 6 publications

(4 citation statements)

References 45 publications

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“…In both case series included in the present review, it was not possible to determine whether HA affected root coverage. Notwithstanding, the RD in Guldener et al's study [29] was comparable to the results obtained in the study by Sculean et al [33] and Stähli et al [47]. On the other hand, Lanzrein et al [28] found higher RD values at follow-up compared to those observed by Górski et al [48].…”

Section: Discussionsupporting

confidence: 74%

Effectiveness of Adjunctive Hyaluronic Acid Application in Surgical Treatment of Gingival Recession Sites

Manfredini,

Beretta,

Maiorana

et al. 2023

Prosthesis

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The aim of this systematic scoping review was to provide scientific evidence on the efficacy and methods of application of hyaluronic acid (HA) in the coverage of gingival recessions in terms of recession depth (RD) reduction, clinical attachment level (CAL) gain and probing depth (PD). An electronic search of the literature on the main databases was conducted. Initially, 405 articles were identified. Finally, four studies were included after the review process. It was not possible to perform a meta-analysis of the articles selected because of the differences among the surgical treatments and commercial formulations and compositions of HA. Both randomized controlled trials in this research examined type 1 gingival recessions treated with a coronally advanced flap. In the selected case series, recessions were treated with either a modified coronally advanced tunnel or laterally closed tunnel combined with a subepithelial connective tissue graft and HA. No significant variation was found in terms of PD. Modifications of CAL are connected to variations of RD; however, RD reduction is similar to the control group. HA seems to improve the clinical outcomes of gingival recession coverage in the short term, but the magnitude is limited. Formulations, surgical techniques and application methods are heterogeneous.

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Section: Discussionsupporting

confidence: 74%

Effectiveness of Adjunctive Hyaluronic Acid Application in Surgical Treatment of Gingival Recession Sites

Manfredini,

Beretta,

Maiorana

et al. 2023

Prosthesis

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“…Probing attachment level (mm) T0 , 1980). In that respect, CTGs have been used clinically to increase the width of KT (Edel, 1974;Stähli et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

“…Contrarily, it had been previously established that the differentiation pattern of epithelialization is conditioned by the connective tissue originating from KT applied to the recipient site (Bernimoulin & Schroeder, 1980). In that respect, CTGs have been used clinically to increase the width of KT (Edel, 1974; Stähli et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

Clinical and histologic evaluation of heterotopic mucosa transpositioning at teeth and dental implants

Imber,

Roccuzzo,

Stähli

et al. 2023

Clinical Oral Implants Res

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AimTo investigate the healing after heterotopic mucosa transpositioning at dental implants and teeth.Materials and MethodsOne hemimandible per dog (n = 4) was allocated to receive 3 implants (test), whereby 3 premolars on the contralateral side served as controls. After osseointegration, a Z‐plasty was performed on the buccal aspect of the test and control sites to heterotopically move the zone of keratinized tissue (KT) into a region with non‐keratinized tissue (nKT) and vice versa. Clinical measurements were performed before (T0) and at 12 weeks following heterotopic transposition (T1). Thereafter, specimens were processed for histological analysis.ResultsClinical measurements revealed that at T1, a band of KT was reestablished at teeth (mean: 2.944 ± 1.866 mm), whereas at implants, the transpositioned nKT resulted in a mucosa without any signs of keratinization (mean: 0 mm; p < .0001). At implant sites, the probing attachment level loss was more pronounced compared to tooth sites (−1.667 ± 1.195 mm and −1.028 ± 0.878 mm, respectively; p = .0076). Histologically, the transpositioned nKT, was accompanied by the formation of KT at the tooth but not at implant sites. The supracrestal soft tissues were statistically significantly higher at tooth compared to implant sites (2.978 ± 0.483 mm and 2.497 ± 0.455 mm, p = .0083). The transpositioned KT remained mostly unaltered in its morphological characteristics.ConclusionsThe findings of this study indicate that: (a) transpositioned KT may retain its morphological characteristics; and (b) transpositioned nKM was accompanied by the formation of KT at the tooth but not at implant sites.

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“…We believe that some critical surgical maneuvers were crucial to the success of root coverage in this case series, mainly the innovative suture technique. Despite the high relevance of the suture, some previous studies did not detail address this procedure 18 , 19 , 20 , 21 . First, using suspending sutures, a fixed anchorage with coronal traction is used to stabilize the graft in the teeth positioned at the mesial and distal ends of the grafted area.…”

Section: Discussionmentioning

confidence: 99%

A modified tunnel technique to treat multiple gingival recessions: Case Series

Guimarães¹,

Andrade

Rebollal³

et al. 2023

Braz. Dent. J.

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This case series reports a modified tunnel technique with connective tissue graft for the root coverage of multiple Miller Class I, II, and III gingival recessions. The modified approach presents an innovative suture technique to improve the stability and position of the graft. Ten patients with multiple gingival recessions (n=85 teeth) received surgical root coverage treatment. The gingival recession height and width were measured and presented as median, minimum, and maximum values. The percentage of the root coverage after at least 12 months expressed the treatment effectiveness. The Shapiro-Wilk test evaluated the normality; pared Wilcoxon test determined the exact P-value for the differences in the height of the gingival recession before and after surgical treatment (α = 0.05). An average of 97.9% (± 5.6%, p < 0.0001) root coverage after treatment occurred, and 73 out of 85 recessions presented complete root coverage after 12 months. Treatment of Miller class I and II gingival recessions resulted in root coverage higher than 99 and class III higher than 95% (p < 0.0001). The presented case series report the efficacy of a modified surgical technique promoting more than 95% of root coverage after 12 months in multiple Miller Class I, II, and III gingival recessions. Well-designed blind randomized controlled trials are needed to validate the proposed technique.

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Recession coverage using the modified coronally advanced tunnel and connective tissue graft with or without enamel matrix derivative: 5-year results of a randomised clinical trial

Cited by 6 publications

References 45 publications

Effectiveness of Adjunctive Hyaluronic Acid Application in Surgical Treatment of Gingival Recession Sites

Effectiveness of Adjunctive Hyaluronic Acid Application in Surgical Treatment of Gingival Recession Sites

Clinical and histologic evaluation of heterotopic mucosa transpositioning at teeth and dental implants

A modified tunnel technique to treat multiple gingival recessions: Case Series

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