head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing
ISSN: 1312-773X (Online)
Issue: 2018, vol. 24, issue3
Subject Area: Dental&Oral Medicine
DOI: 10.5272/jimab.2018243.2149
Published online: 03 September 2018

Literature review

J of IMAB. 2018 Jul-Sep;24(3):2149-2159
Denislav Emilov1ORCID logo, Elitsa Deliverska2ORCID logo Corresponding Autoremail, .
1) Department of Periodontology, Faculty of Dental Medicine, Medical University – Sofia, Bulgaria.
2) Department of Oral and Maxillofacial surgery, Faculty of Dental Medicine, Medical University, Sofia, Bulgaria.

Periodontal plastic surgery is part of mucogingival therapy. The aim of this surgical procedure is to prevent or correct anatomic, developmental, traumatic or disease-induced defects of the gingiva, alveolar mucosa or bone.
This definition includes various soft- and hard-tissue procedures aimed at gingival augmentation, root coverage, correction of mucosal defects at implants, crown lengthening, gingival preservation at ectopic tooth eruption, removal of aberrant frenum, prevention of ridge collapse associated with tooth extraction and augmentation of the edentulous ridge. This review focuses on gingival recession defects, their diagnosis and prognosis and the surgical procedures for root coverage. Etiology of gingival recession is multifactorial and include: anatomical, physiological and pathological factors. The treatment of gingival recession defects is indicated for esthetic reasons, to reduce root hypersensitivity and to create or augment keratinized tissue. Gingival recession can be treated with various surgical procedures, and root coverage can be obtained irrespective of the surgical approach adopted.

Keywords: gingival recession, surgery, soft tissue graft,

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Please cite this article as: Emilov D, Deliverska E. Surgical treatment of gingival recession with soft tissue graft procedure. J of IMAB. 2018 Jul-Sep;24(3):2149-2159. DOI: 10.5272/jimab.2018243.2149

Corresponding AutorCorrespondence to: Elitsa Georgieva Deliverska, Associate Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Medical University Sofia; 1, Georgi Sofiiski Blvd., 1431 Sofia, Bulgaria; E-mail: elitsadeliverska@yahoo.com,

1. Geiger AM. Mucogingival problems and the movement of mandibular incisors: a clinical review. Am J Orthod. 1980 Nov;78(5):511-27. [CrossRef]
2. Zucchelli G, Mounssif I. Periodontal plastic surgery. Periodontology 2000. 2015 Jun;68(1):333-68. [PubMed] [CrossRef]
 3. Roccuzzo M, Bunino M, Needleman I, Sanz M. Periodontal plastic surgery for treatment of localized gingival recessions: a systematic review. J Clin Periodontol. 2002; 29 Suppl 3:178-94. [PubMed]
4. Wennstrom JL. Mucogingival surgery. In: Proceedings of the 1st European Workshop on Periodontology. Lang NP, Karring T, editors.  London: Quintessence, 1994; pp.193-209.
5. Miller PD Jr. A classification of marginal tissue recession. Int J Periodontics Restorative Dent. 1985; 5(2):8-13. [PubMed]
6. Wennstrom JL, Zucchelli G, Pini Prato G. Part 13: Reconstructive Therapy. 44. Mucogingival Therapy – Periodontal Plastic Surgery. In:  Clinical Periodontology and Implant Dentistry, 5th Edition. Lindhe J, Lang NP, Karring T, editors. May 2012, Wiley-Blackwell. Part 13: 44. 955-1028. [Internet]
7. Grupe HE. Modified technique for the sliding flap operation. J Periodontol. 1966 Nov-Dec;37(6):491-5. [PubMed]
8. Allen AL. Use of the supraperiosteal envelope in soft tissue grafting for root coverage. II. Clinical results. Int J Periodontics Restorative Dent. 1994 Aug;14(4):302-15. [PubMed]
9. Zucchelli G, Cesari C, Amore C, Montebugnoli L, De Sanctis M. Laterally moved, coronally advanced flap: a modified surgical approach for isolated recession-type defects. J Periodontol. 2004 Dec;75(12):1734-41. [PubMed] [CrossRef]
10. Pini Prato G, Clauser C, Cortellini P, Tinti C, Vincenzi G, Pagliaro U. Guided tissue regeneration versus mucogingival surgery in the treatment of human buccal recessions. A 4-year follow-up study. J Periodontol. 1996 Nov;67(11):1216-23. [PubMed] [CrossRef]
11. De Sanctis M, Zucchelli G. Coronally advanced flap: a modified surgical approach for isolated recession-type defects: three-year results. J Clin Periodontol. 2007 Mar;34(3):262-8. [PubMed] [CrossRef]
12. Zucchelli G, De Sanctis M. Long-term outcome following treatment of multiple Miller class I and II recession defects in esthetic areas of the mouth. J Periodontol. 2005 Dec;76(12):2286-92. [PubMed] [CrossRef]
13. Pini Prato G, Rotundo R, Franceschi D, Cairo F, Cortellini P, Nieri M. Fourteen-year outcomes of coronally advanced flap for root coverage: follow-up from a randomized trial. J Clin Periodontol. 2011 Aug;38(8):715-20. [PubMed] [CrossRef]
14. Kunjamma S, Varma BR, Nandakumar K. A comparative evaluation of coverage of denuded root surface by gingival autograft and lateral sliding flap operation. J Indian Dent Assoc. 1986 Dec;58(12):527-34. [PubMed]
15. Caffesse RG, Guinard EA. Treatment of localized gingival recessions. Part II. Coronally repositioned flap with a free gingival graft. J Periodontol. 1978 Jul;49(7):357-361. [CrossRef]
16. Lins LH, de Lima AF, Sallum AW. Root coverage: comparison of coronally positioned flap with and without titanium-reinforced barrier membrane. J Periodontol. 2003 Feb;74(2):168-74. [PubMed] [CrossRef]
17. McGuire MK, Cochran DL. Evaluation of human recession defects treated with coronally advanced flaps and either enamel matrix derivative or connective tissue. Part 2: Histological evaluation. J Periodontol. 2003 Aug;74(8):1126-35. [PubMed] [CrossRef]
18. Borghetti A, Laborde G, Borghetti G, Fourel J. [Gingival thickening with a submerged connective tissue graft.] [in French] J Parodontol. 1990 Nov;9(4):311-7. [PubMed]
19. Cairo F, Pagliaro U, Nieri M. Treatment of gingival recession with coronally advanced flap procedures: a systematic review. J Clin Periodontol. 2008 Sep;35(8 Suppl):136-62. [PubMed] [CrossRef]
20. Zucchelli G, Amore C, Sforza NM, Montebugnoli L, De Sanctis M. Bilaminar techniques for the treatment of recession-type defects. A comparative clinical study. J Clin Periodontol. 2003 Oct;30(10):862-70.  [PubMed]
21. Lorenzana E, Allen E. The single-incision palatal harvest technique: a strategy for esthetics and patient comfort. Int J Periodontics Restorative Dent. 2000 Jun;20(3):297-305. [PubMed]
22. Zucchelli G, Mele M, Stefanini M, Mazzotti C, Marzadori M, Montebugnoli L, et al. Patient morbidity and root coverage outcome after subepithelial connective tissue and de-epithelialized grafts: a comparative randomized-controlled clinical trial. J Clin Periodontol. 2010  Aug 1;37(8):728-38. [PubMed]
23. Chambrone L, Lima LA, Pustiglioni FE, Chambrone LA. Systematic review of periodontal plastic surgery in the treatment of multiple recession-type defects. J Can Dent Assoc. 2009 Apr;75(3):203a–203f. [PubMed]
24. Carvalho PF, da Silva RC, Cury PR, Joly JC. Modified coronally advanced flap associated with a subepithelial connective tissue graft for the treatment of adjacent multiple gingival recessions. J Periodontol. 2006 Nov;77(11):1901-6. [PubMed] [CrossRef]
25. Chambrone L, Chambrone L. Subepithelial connective tissue grafts in the treatment of multiple recession-type defects. J Periodontol. 2006 May;77(5):909-16. [PubMed]
26. Pini Prato G, 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 Jul;37(7):644-50. [PubMed] [CrossRef]
27. Aroca S, Keglevich T, Nikolidakis D, Gera I, Nagy K, Azzi R, Etienne D. Treatment of class III multiple gingival recessions: a randomized-clinical trial. J Clin Periodontol. 2010 Jan;37(1):88-97. [PubMed] [CrossRef]
28. Woodyard JG, Greenwell H, Hill M, Drisko C, Iasella JM, Scheetz J. The clinical effect of acellular dermal matrix on gingival thickness and root coverage compared to coronally positioned flap alone. J Periodontol. 2004 Jan;75(1):44-56. [PubMed]
29. Sanz M, Lorenzo R, Aranda J, Martin C, Orsini M. Clinical evaluation of a new collagen matrix (Mucograft prototype) to enhance the width of keratinized tissue in patients with fixed prosthetic restorations: a randomized prospective clinical trial. J Clin Periodontol. 2009 Oct;36(10):868-76. [PubMed] [CrossRef]
30. Jepsen K, Jepsen S, Zucchelli G, Stefanini M, de Sanctis M, Baldini N, et al. Treatment of gingival recession defects with a coronally advanced flap and a xenogeneic collagen matrix: a multicenter randomized clinical trial. J Clin Periodontol. 2013 Jan;40(1):82-89. [PubMed]
31. Lowenguth RA, Blieden TM. Periodontal regeneration: root surface demineralization. Periodontol 2000. 1993 Feb;1(1):54-68. [PubMed]
32. Vignoletti F, Nunez J, Discepoli N, De Sanctis F, Caffesse R, Munoz F, et al. Clinical and histological healing of a new collagen matrix in combination with the coronally advanced flap for the treatment of Miller class-I recession defects: an experimental study in the minipig. J Clin Periodontol. 2011 Sep;38(9):847-55. [PubMed] [CrossRef]
33. Chan HL, Chun YH, MacEachern M, Oates TW. Does Gingival Recession Require Surgical Treatment? Dent Clin North Am. 2015 Oct;59(4):981-96. [PubMed] [CrossRef]
34. Shkreta M, Atanasovska-Stojanovska A, Dollaku B, Belazelkoska Z. Exploring the Gingival Recession Surgical Treatment Modalities: A Literature Review. Open Access Maced J Med Sci. 2018 Apr 2;6(4):698-708. [PubMed] [CrossRef]
35. Gilbert LR, Lohra P, Mandlik VB, Rath SK, Jha AK. Comparative evaluation of surgical modalities for coverage of gingival recession: An Armed Forces Medical College perspective. Med J Armed Forces India. 2015 Jan;71(1):53-9. [PubMed] [CrossRef].

Received: 23 April 2018
Published online: 03 September 2018

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