Possibilities of modern procedures in gingival recession therapy

Abstract

This study was designed to compare the effectiveness and predictability of GTR and connective tissue graft in the treatment of gingival recession. 15 recessions Miller class II and III were treated with bioabsorbable barrier and coronally advanced flap. The same number of defects was treated with connective tissue graft in combination with coronally advanced flap. Clinical recordings included hygiene standards and recession depth (RD) probing depth (PD), clinical attachment level (CAL) and keratinized tissue width (KT) Mean (RD) was statistically significant decreased from 5,47mm presurgery to 0.73mm with GTR (87,76%) and from 5,93mm to 0.60 with CTG (89.9%). Prevalence of complete root coverage was 40% for the GTR and 46,66% for CTG group. No statistically significant differences between treatment groups were observed in this study Treatment of gingival recessions with CTG and GTR present effective and highly predictable mucogingival plastic surgical procedures.

Studija je izvedena u cilju procene efikasnosti postupaka usmerene tkivne regeneracije (GTR) i auto transplantata vezivnog tkiva sa periostom u rešavanju problema izolovane recesije gingive u parodontopatiji. Istraživanjem je obuhvaćeno 30 zuba sa recesijama gingive klase II i III po Milleru. U terapiji 15 recesija primenjena je resorptivna membrana i koronarno pomereni režanj (GTR grupa). Isti broj recesija na kontralateralnoj strani vilice je zbrinjavan autotransplantatom vezivnog tkiva sa periostom u kombinaciji sa koronarno pozicioniranim režnjem (TVT grupa). Korišćeni su sledeći klinički parametri: vertikalna dubina recesije (VDR), nivo pripojnog epitela (NPE) i širina keratinizovane gingive (KG). Na osnovu analize srednje vrednosti za dubinu recesije (VDR) ustanovljeno je statistički značajno smanjenje vrednosti ovog parametra 6 meseci nakon tretmana u GTR grupi (sa 5,47mm pre na 1.73mm - 69.4%). U TVT grupi ova vrednost VDR pre terapije je iznosila 5.93mm a nakon šest meseci 0.60mm (89.9%). Rezultati studije ukazuju da hirurški postupci uz korišćenje principa usmerene tkivne regeneracije (GTR) odnosno slobodnog auto transplantata vezivnog tkiva sa periostom (TVT) predstavljaju efikasne i sa kliničkog aspekta izuzetno primenljive terapijske postupke u rešavanju problema izolovane recesije gingive.