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Elena RDGP, Miren VF, Ana-María GDLF, Xabier MM, Luis-Antonio AZ. Analysis of the treatment of RT2 recessions with a xenogeneic collagen matrix vs. connective tissue graft combined with a coronally advanced flap. A double-blinded randomized clinical trial. Clin Oral Investig 2024; 28:215. [PMID: 38489063 PMCID: PMC10943151 DOI: 10.1007/s00784-024-05602-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/05/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVES To compare the clinical efficacy in terms of mean root coverage in RT2 recession treated with a coronally advanced flap combined with a xenogeneic collagen matrix versus a connective tissue graft. MATERIALS AND METHODS A total of 20 patients were randomized to receive one of two treatments: coronally advanced flap + xenogeneic collagen matrix (test group) and coronally advanced flap + connective tissue graft (control group). Patient-related outcomes measures and professional aesthetic assessment by root esthetic score were performed. A descriptive and analytical statistical analysis of the variables was performed. RESULTS At 12 months, the mean root coverage was 56.48% in the test group and 69.72% in the control group (p = 0.048), with a 35% and 40% complete root coverage in the xenogeneic collagen matrix and connective tissue graft, respectively. Test group presented less pain (3.65 vs. 5.2 VAS units) (p = 0.015) and less surgical time (45 vs. 49.15 min) (p = 0.004) than control group. CONCLUSION The use of xenogeneic collagen matrix in RT2 recessions was effective for recession reduction to those obtained using autologous grafts; with the advantage that the duration of surgery and patient morbidity decreased. Therefore, xenogeneic collagen matrix in RT2 recessions could be an alternative to autologous grafts. CLINICAL RELEVANCE The use of xenogeneic collagen matrix decreases the surgery time and patient morbidity but connective tissue graft results in significantly better mean root coverage and complete root coverage. Xenogeneic collagen matrix can be used in the treatment of RT2 gingival recessions. STUDY REGISTRATION NCT03344315.
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Affiliation(s)
| | | | - García-De-La-Fuente Ana-María
- Research Group: GIU21/042. Department of Stomatology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, Biscay, Leioa, 48940, Spain.
- Research Group: GIU21/042. Department of Stomatology, University of the Basque Country (UPV/EHU), Biscay, Spain.
| | - Marichalar-Mendía Xabier
- Research Group: GIU21/042. Department of Nursery I. Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Biscay, Spain
| | - Aguirre-Zorzano Luis-Antonio
- Research Group: GIU21/042. Department of Stomatology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, Biscay, Leioa, 48940, Spain
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Vogt L, Pretzl B, Eickholz P, Ramich T, Nickles K, Petsos H. Oral health-related quality of life and patient-reported outcome measures after 10 years of supportive periodontal care. Clin Oral Investig 2023; 27:2851-2864. [PMID: 36723714 PMCID: PMC10264521 DOI: 10.1007/s00784-023-04876-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/22/2023] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim of this retrospective study was to evaluate the oral health-related quality of life (oHRQoL) and patient-reported outcome measures (PROMs) after 10 years of supportive periodontal care (SPC). MATERIAL AND METHODS Patients were re-examined 120±12 months after active periodontal therapy. Dental and periodontal status and oHRQoL by completing Oral Health Impact Profile-G49 (OHIP-G49) and PROMs by marking a visual analogue scale (VAS) for self-perceived esthetics (VASe), chewing function (VASc), and hygiene ability (VASh) were assessed. Patient- and tooth-related factors (age, insurance status, number of SPC, compliance, change of therapist, smoking, tooth loss, need for surgery or antibiotic intake, bleeding on probing (BOP), periodontal inflamed surface area) influencing oHRQoL and PROMs were evaluated. RESULTS One hundred eight periodontally compromised patients (59 female, mean age 65.4±10.7 years) lost 135 teeth during 10 years of SPC. At re-examination, 1.8% of all sites showed PPD ≥6mm. The mean OHIP-G49 sum score was 17.6±18.5, and VAS resulted in 76.0±22.5 (VASe), 86.3±16.3 (VASc), and 79.8±15.8 (VASh). Linear regression analyses identified a positive correlation with oHRQoL and/or PROMs for private insurance status (OHIP-G49, p=0.015, R2=0.204; VASc, p=0.005, R2=0.084; VASh, p=0.012, R2=0.222) and compliance to SPC (VASe, p=0.032; R2=0.204), as well as a negative correlation for active smoking (VASc, p=0.012, R2=0.084), increased BOP (VASh, p=0.029, R2=0.222) at the start of SPC, and number of lost molars (VASh, p=0.008, R2=0.222). CONCLUSION It is realistic to obtain satisfactory oHRQoL and PROM values in most of the patients after 10 years of SPC. The identified factors may help to predict patient satisfaction in the long-term course of therapy. CLINICAL RELEVANCE Systematic therapy of periodontally compromised patients provides values for oHRQoL and PROMs in a favorable range 10 years after therapy. This should encourage dentists to implement SPC in their daily routine. CLINICAL TRIAL NUMBER NCT03048045.
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Affiliation(s)
- Luca Vogt
- Private practice, Hundemstraße 4, 57368, Lennestadt, Germany
| | - Bernadette Pretzl
- Dental Academy, Lorenzstraße 7, 76135, Karlsruhe, Germany
- Ruprecht-Karls-University Heidelberg, 69117, Heidelberg, Germany
| | - Peter Eickholz
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany
| | - Tatjana Ramich
- Private practice, An der Stuferklinik 2, 73557, Mutlangen, Germany
| | - Katrin Nickles
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany
- Private practice, Talstraße 1a, 68259, Mannheim, Germany
| | - Hari Petsos
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany.
- Private practice, Schloßstraße 25, 35510, Butzbach, Germany.
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Periodontal Care and Treatment Provision by General Dentists in France. Int Dent J 2022; 72:667-673. [PMID: 35422317 PMCID: PMC9485509 DOI: 10.1016/j.identj.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/28/2022] [Accepted: 02/02/2022] [Indexed: 11/21/2022] Open
Abstract
Aim Methods Results Conclusions
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Smile esthetic evaluation of mucogingival reconstructive surgery. Odontology 2020; 109:295-302. [PMID: 32772215 PMCID: PMC7790786 DOI: 10.1007/s10266-020-00544-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/27/2020] [Indexed: 12/05/2022]
Abstract
To assess the difference in smile esthetic impact of Coronally Advanced Flap (CAF) with or without the adjunct of a collagen matrix (CMX) used as root coverage procedures. Subjects with esthetic demands showing multiple upper gingival recessions of at least 2 mm, without interproximal attachment loss and cervical abrasion no more than 1 mm were recruited and randomized to CAF plus CMX or CAF alone. The Smile Esthetic Index (SEI) was adopted to quantify the quality of the smile recorded at baseline and 12 months after treatment for each treatment group. In addition, between group difference in the SEI was calculated. 24 Patients were treated and analysed. At baseline, mean gingival recession depths were 2.3 ± 0.7 mm for Test group and 2.6 ± 1.0 mm for Control group. After 1 year, the residual recession depth was 0.3 ± 0.4 mm in the CAF + CMX group and 0.6 ± 0.3 mm in the control group. The SEI at baseline was 8.1 ± 1.0 and 7.9 ± 0.7 for Test and Control group, respectively. The between groups difference at 12 months in SEI was 0.4 (95% C.I. − 0.0 to 0.8, P = 0.0697). Twelve months after treatment, CAF + CMX provided a similar SEI compared to CAF alone and the adjunct of a collagen matrix did not show a different impact on the smile esthetic appearance.
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Yılmaz M, Oduncuoğlu BF, Nişancı Yılmaz MN. Evaluation of patients' perception of gingival recession, its impact on oral health-related quality of life, and acceptance of treatment plan. Acta Odontol Scand 2020; 78:454-462. [PMID: 32379509 DOI: 10.1080/00016357.2020.1758773] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: Gingival recessions (GR) may cause aesthetic and hypersensitivity complaints which might affect oral health-related quality of life (OHRQoL). The aim of this study was to evaluate the patients' awareness of their own GR, the impact of GR on OHRQoL and the acceptance of suggested treatment modalities.Materials and Methods: This cross-sectional study was conducted with 205 patients. The demographic variables were recorded and patients' perception of GR was questioned. Full-mouth examination was carried out and clinical parameters were recorded. Gingival recessions, GR related complaints were evaluated and GR treatments were suggested and acceptance were also recorded by the examiner. The patients filled out OHRQoL-United Kingdom (OHRQoL-UK) questionnaire regarding to their GR and were asked if GR have/would have impact on oral health and if the GR will/would get worsen. Data was analysed with independent t test and Mann-Whitney U test.Results: 4819 teeth were evaluated and 733 GR examined in 147 patients. Fifty-seven patients were unaware of their GR. A strong belief that GR have impact on oral health (88.78%) and GR will progress (86.34%) was detected. Acceptance of treatment was increased and non-invasive modalities were preferred if patients had complaints. The awareness of GR status increases and the misperception decreases the OHRQoL-UK scores. The results revealed that hypersensitivity decreases the OHRQoL-UK scores and aesthetic concerns and hypersensitivity decreases the OHRQoL-UK physical scores significantly (p < .05).Conclusions: The results indicated that the patients might be unaware of their GR and the GR related factors may lead to poorer OHRQoL.
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Affiliation(s)
- Merve Yılmaz
- FKT Oral and Dental Health Center, Adana, Turkey
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Graetz C, Bäumer A, Eickholz P, Kocher T, Petsos H, Pretzl B, Schwendicke F, Holtfreter B. Long-term tooth retention in periodontitis patients in four German university centres. J Dent 2020; 94:103307. [DOI: 10.1016/j.jdent.2020.103307] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/31/2020] [Accepted: 02/26/2020] [Indexed: 10/24/2022] Open
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Bäumer A, Weber D, Staufer S, Pretzl B, Körner G, Wang Y. Tooth loss in aggressive periodontitis: Results 25 years after active periodontal therapy in a private practice. J Clin Periodontol 2019; 47:223-232. [DOI: 10.1111/jcpe.13225] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 10/08/2019] [Accepted: 11/15/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Amelie Bäumer
- Department of Conservative Dentistry Section of Periodontology Clinic for Oral, Dental and Maxillofacial Diseases University Hospital Heidelberg Heidelberg Germany
- Private Practice Bielefeld Germany
| | - Dorothea Weber
- Institute of Medical Biometry and Informatics (IMBI) University Hospital Heidelberg Heidelberg Germany
| | | | - Bernadette Pretzl
- Department of Conservative Dentistry Section of Periodontology Clinic for Oral, Dental and Maxillofacial Diseases University Hospital Heidelberg Heidelberg Germany
| | | | - Yan Wang
- Private Practice München Germany
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El Sayed N, Cosgarea R, Rahim S, Giess N, Krisam J, Kim TS. Patient-, tooth-, and dentist-related factors influencing long-term tooth retention after resective therapy in an academic setting-a retrospective study. Clin Oral Investig 2019; 24:2341-2349. [PMID: 31720850 DOI: 10.1007/s00784-019-03091-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 09/22/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate long-term (≥5 years) tooth survival after resective therapy of multi-rooted, periodontally treated teeth and investigate the influence of patient-, tooth-, and dentist-related risk factors on tooth loss. MATERIALS AND METHODS A total of 128 patients with root-resected molars were reexamined. Patient-, tooth-, and dentist-related factors were assessed. Tooth survival times were estimated using the Kaplan-Meier method in addition to a Cox proportional hazard frailty model with survival as the dependent outcome to assess an association with predictor variables. RESULTS Overall, 100 patients with 130 molars were included. The average postoperative reevaluation period was a 9.62 ± 3.08 year showing an overall survival rate of 56.9% after resective therapy. A cumulative survival rate of 69% (95% CI (61%; 77%)) after 5 years decreasing to 48% (95% CI (35%; 61%)) after 15 years was detected. The median survival time of resected molars was 13.83 years (95% CI (8.75; ∞)). Adherence, smoking, and insurance status were detected to significantly influence the risk for loss of molars after resective therapy. CONCLUSIONS Resective periodontal procedures can still be considered an option to retain periodontally compromised molars. In contrast to dentist- and tooth-related factors, patient-related factors impacted significantly upon tooth survival. CLINICAL RELEVANCE Periodontally compromised molars could be retained in more than 50% of the cases thus prolonging their life span significantly. This information shall be valuable for clinicians in decision-making, treatment planning, and postoperative management. The weighting of resective therapy to implants especially with regards to the risk of peri-implantitis should be considered.
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Affiliation(s)
- Nihad El Sayed
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Im Neuenheimer Feld, 400 69120, Heidelberg, Germany.
| | - Raluca Cosgarea
- Department of Periodontology, Philipps University Marburg, Marburg, Germany
- Department of Prosthetic Dentistry, University Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Sonja Rahim
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Im Neuenheimer Feld, 400 69120, Heidelberg, Germany
| | - Natalia Giess
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Im Neuenheimer Feld, 400 69120, Heidelberg, Germany
| | - Johannes Krisam
- Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, Heidelberg, Germany
| | - Ti-Sun Kim
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Im Neuenheimer Feld, 400 69120, Heidelberg, Germany
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Deo SD, Shetty SK, Kulloli A, Chavan R, Dholakia P, Ligade S, Dharmarajan G. Efficacy of free gingival graft in the treatment of Miller Class I and Class II localized gingival recessions: A systematic review. J Indian Soc Periodontol 2019; 23:93-99. [PMID: 30983778 PMCID: PMC6434727 DOI: 10.4103/jisp.jisp_102_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Currently, the leading theme in mucogingival surgery is the correction of gingival recession defects. Free gingival graft (FGG) has been successfully in use in this category of reconstructive therapeutic modality. Objectives The aim of this systematic review was to evaluate the literature with respect to efficacy of FGG in the management of Miller Class I and II localized gingival recessions. Data Sources Search strategies were performed via electronic database which included Pubmed-Medline, Google scholar and manual search using University library resources. Two reviewers assessed the eligibility of the studies. Study Eligibility Criteria Controlled clinical trials, randomized clinical trials and longitudinal studies evaluating recession areas treated by FGG with minimum of 6 months follow up were included. In-vitro and animal studies, studies mainly done on Miller Class III and IV gingival recession defect, studies on multiple gingival recessions and case series and case reports were excluded from the search. Results The electronic and manual search identified a total of 557 articles. A final screen consisted of 39 articles out of which 17 articles were selected for full-text assessment. Finally, 7 articles were selected for detailed evaluation for this systematic review. FGG has shown significant results in all the studies except for one study. Conclusion FGG produces substantial results, however, highly depends on the case selection and operator's skill and experience. FGG gives an impression of being the best alternative option in zones where gingival recession presents with inadequate width of attached gingiva and depth of vestibular fornix.
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Affiliation(s)
- Sukhada Dileep Deo
- Department of Periodontics, Dr. D. Y. Patil Vidyapeeth, Dr. D. Y. Patil Dental College and Hospital, Pune, Maharashtra, India
| | - Sharath Kumara Shetty
- Department of Periodontics, Dr. D. Y. Patil Vidyapeeth, Dr. D. Y. Patil Dental College and Hospital, Pune, Maharashtra, India
| | - Anita Kulloli
- Department of Periodontics, Dr. D. Y. Patil Vidyapeeth, Dr. D. Y. Patil Dental College and Hospital, Pune, Maharashtra, India
| | - Ruchira Chavan
- Department of Periodontics, Dr. D. Y. Patil Vidyapeeth, Dr. D. Y. Patil Dental College and Hospital, Pune, Maharashtra, India
| | - Poonam Dholakia
- Department of Periodontics, Dr. D. Y. Patil Vidyapeeth, Dr. D. Y. Patil Dental College and Hospital, Pune, Maharashtra, India
| | - Shruti Ligade
- Department of Periodontics, Dr. D. Y. Patil Vidyapeeth, Dr. D. Y. Patil Dental College and Hospital, Pune, Maharashtra, India
| | - Gopalakrishnan Dharmarajan
- Department of Periodontics, Dr. D. Y. Patil Vidyapeeth, Dr. D. Y. Patil Dental College and Hospital, Pune, Maharashtra, India
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Cortellini P, Bissada NF. Mucogingival conditions in the natural dentition: Narrative review, case definitions, and diagnostic considerations. J Periodontol 2018; 89 Suppl 1:S204-S213. [DOI: 10.1002/jper.16-0671] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/03/2018] [Accepted: 02/06/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Pierpaolo Cortellini
- European Group on Periodontal Research (ERGOPerio, CH); private practice; Florence Italy
| | - Nabil F. Bissada
- Department of Periodontics; Case Western Reserve University; School of Dental Medicine; Cleveland OH USA
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11
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Cortellini P, Bissada NF. Mucogingival conditions in the natural dentition: Narrative review, case definitions, and diagnostic considerations. J Clin Periodontol 2018; 45 Suppl 20:S190-S198. [DOI: 10.1111/jcpe.12948] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/03/2018] [Accepted: 02/06/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Pierpaolo Cortellini
- European Group on Periodontal Research (ERGOPerio, CH); private practice; Florence Italy
| | - Nabil F. Bissada
- Department of Periodontics; Case Western Reserve University; School of Dental Medicine; Cleveland OH USA
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12
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Kopp SL, Ramseier CA, Ratka-Krüger P, Woelber JP. Motivational Interviewing As an Adjunct to Periodontal Therapy-A Systematic Review. Front Psychol 2017; 8:279. [PMID: 28293208 PMCID: PMC5329060 DOI: 10.3389/fpsyg.2017.00279] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 02/14/2017] [Indexed: 12/11/2022] Open
Abstract
Aim: Periodontal therapy is highly dependent on a patient's long-term adherence with regard to oral hygiene, diet, and regular check-ups at the dentist. Motivational Interviewing (MI) is a client-centered, directive method for encouraging a patients' behavioral health change. The aim of this systematic review was to reveal the effects of MI as an adjunct to periodontal therapy. Methods: Three databases (PubMed, Cochrane Library, and Web of Science) were reviewed for randomized controlled clinical trials. Articles were included when using MI as an adjunct to periodontal therapy and presenting clinical periodontal and oral hygiene related parameters. Two authors independently coded the relevant articles. Results: The search yielded 496 articles. After analysis and exclusion, a total of five papers could be included. The quality of the articles ranged between 72–88%. The two independent raters showed a high inter-rater reliability (Cohens-Kappa = 0.89). In two studies MI showed a significant positive effect on bleeding on probing and plaque values. One study showed improvement of self-efficacy in interdental cleaning. Two studies showed no influence of MI on periodontal parameters of the patients. Conclusion: The use of MI as an adjunct to periodontal therapy might have a positive influence on clinical periodontal parameters (plaque values, gingival, and periodontal inflammation) and psychological factors related to oral hygiene (self-efficacy). Due to the low body of evidence further studies are needed. Future studies should include fidelity measures of the applied MI, a high number of counselors, several MI sessions, and long-term study follow-up to show potential effects.
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Affiliation(s)
- Svenja L Kopp
- Department of Operative Dentistry and Periodontology. University Freiburg Medical Center Freiburg im Breisgau, Germany
| | - Christoph A Ramseier
- Department of Periodontology and Fixed Prosthodontics, University of Bern, School of Dental Medicine Bern, Switzerland
| | - Petra Ratka-Krüger
- Department of Operative Dentistry and Periodontology. University Freiburg Medical Center Freiburg im Breisgau, Germany
| | - Johan P Woelber
- Department of Operative Dentistry and Periodontology. University Freiburg Medical Center Freiburg im Breisgau, Germany
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Chan HL, Chun YHP, MacEachern M, Oates TW. Does Gingival Recession Require Surgical Treatment? Dent Clin North Am 2015; 59:981-96. [PMID: 26427577 DOI: 10.1016/j.cden.2015.06.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Gingival recession represents a clinical condition in adults frequently encountered in the general dental practice. Clinicians often face dilemmas of whether or not to treat such a condition surgically. An initial condensed literature search was performed using a combination of gingival recession and surgery controlled terms and keywords. An analysis of the search results highlights the limited understanding of the factors that guide the treatment of gingival recession. Understanding the cause, prognosis, and treatment of gingival recession continues to offer many unanswered questions and challenges in periodontics as we strive to provide the best care possible for our patients.
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Affiliation(s)
- Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, R3323B 1011 North University Avenue, Ann Arbor, MI 48105, USA
| | - Yong-Hee Patricia Chun
- Department of Periodontics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA; Department of Cellular and Structural Biology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - Mark MacEachern
- Taubman Health Sciences Library, University of Michigan, 1135 East Catherine Street, Ann Arbor, MI 48109, USA
| | - Thomas W Oates
- Department of Periodontics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
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Preferences of UK-Based Dentists When Undertaking Root Coverage and Regenerative Procedures: A Pilot Questionnaire Study. Int J Dent 2014; 2014:548519. [PMID: 24616737 PMCID: PMC3927746 DOI: 10.1155/2014/548519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 11/08/2013] [Accepted: 12/05/2013] [Indexed: 11/17/2022] Open
Abstract
Objectives. The purpose of the present study was to evaluate the awareness and preferences of registered United Kingdom (UK) dentists specialising or with an interest in periodontics in root coverage and regenerative procedures. Methods. A cross-sectional postal survey of 366 dentists was conducted. The questionnaire was divided in two sections and most of the questions were giving the option of multiple answers. Frequencies and associations between the demographic profiles of the participants with their answers were evaluated. Results. 63% of dentists with an interest in periodontics and 32% of specialists returned the questionnaire. Guided tissue regeneration procedures and the use of enamel matrix derivatives were recommended for the reconstruction of bony defects and both subepithelial connective tissue graft and coronally advanced flap with or without enamel matrix derivatives were the most popular choices for root coverage. Smoking was considered a contraindication by most of the participants and conflicting responses were given regarding the use of antibiotics as part of the care following regenerative procedures. Conclusions. The participants incorporated both traditional and “novel” techniques and products in reconstructive procedures and appeared to be up to date with the evidence from the dental literature. However, it was evident that there was confusion regarding the role of antibiotics in regenerative procedures.
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Kim SM, Choi YH, Kim YG, Park JW, Lee JM, Suh JY. Analysis of the Esthetic Outcome after Root Coverage Procedures Using a Comprehensive Approach. J ESTHET RESTOR DENT 2013; 26:107-18. [DOI: 10.1111/jerd.12085] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sung Mi Kim
- Department of Periodontology; School of Dentistry, Kyungpook National University; Daegu Korea
| | - Youn Hee Choi
- Department of Preventive Dentistry; School of Dentistry, Kyungpook National University; Daegu Korea
| | - Yong Gun Kim
- Department of Periodontology; School of Dentistry, Kyungpook National University; Daegu Korea
| | - Jin Woo Park
- Department of Periodontology; School of Dentistry, Kyungpook National University; Daegu Korea
| | - Jae Mok Lee
- Department of Periodontology; School of Dentistry, Kyungpook National University; Daegu Korea
| | - Jo Young Suh
- Department of Periodontology; School of Dentistry, Kyungpook National University; Daegu Korea
- Institute for Hard Tissue and Bio-tooth Regeneration; School of Dentistry, Kyungpook National University; Daegu Korea
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Singh H, Singh H. Bioactive amnion as a guided tissue regeneration (GTR) membrane for treatment of isolated gingival recession. A case report. Indian J Dent 2013. [DOI: 10.1016/j.ijd.2012.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Nieri M, Pini Prato GP, Giani M, Magnani N, Pagliaro U, Roberto R. Patient perceptions of buccal gingival recessions and requests for treatment. J Clin Periodontol 2013; 40:707-12. [DOI: 10.1111/jcpe.12114] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2013] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | | | | | - Rotundo Roberto
- Private practice; Florence Italy
- Eastman Dental Institute; University College of London; London UK
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Douglas de Oliveira DW, Oliveira-Ferreira F, Flecha OD, Gonçalves PF. Is Surgical Root Coverage Effective for the Treatment of Cervical Dentin Hypersensitivity? A Systematic Review. J Periodontol 2013; 84:295-306. [DOI: 10.1902/jop.2012.120143] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Pradeep K, Rajababu P, Satyanarayana D, Sagar V. Gingival recession: review and strategies in treatment of recession. Case Rep Dent 2012; 2012:563421. [PMID: 23082256 PMCID: PMC3467775 DOI: 10.1155/2012/563421] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 07/08/2012] [Indexed: 11/18/2022] Open
Abstract
One of the most common esthetic concerns associated with the periodontal tissues is gingival recession. Gingival recession is the exposure of root surfaces due to apical migration of the gingival tissue margins; gingival margin migrates apical to the cementoenamel junction. Although it rarely results in tooth loss, marginal tissue recession is associated with thermal and tactile sensitivity, esthetic complaints, and a tendency toward root caries. This paper reviews etiology, consequences, and the available surgical procedures for the coverage of exposed root surfaces, including three case reports.
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Affiliation(s)
- Koppolu Pradeep
- Department of Periodontics, Sri Sai College of Dental Surgery, Vikarabad, Andhra Pradesh, India
| | - Palaparthy Rajababu
- Department of Periodontics, Kamineni Institute of Dental Sciences, Narketpally, Andhra Pradesh, India
| | - Durvasula Satyanarayana
- Department of Periodontics, Kamineni Institute of Dental Sciences, Narketpally, Andhra Pradesh, India
| | - Vidya Sagar
- Department of Periodontics, Kamineni Institute of Dental Sciences, Narketpally, Andhra Pradesh, India
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Bäumer A, Pretzl B, Cosgarea R, Kim TS, Reitmeir P, Eickholz P, Dannewitz B. Tooth loss in aggressive periodontitis after active periodontal therapy: patient-related and tooth-related prognostic factors. J Clin Periodontol 2011; 38:644-51. [PMID: 21564157 DOI: 10.1111/j.1600-051x.2011.01733.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess prognostic factors for tooth loss after active periodontal therapy (APT) in patients with aggressive periodontitis (AgP) at tooth level. MATERIAL AND METHODS Eighty-four patients with AgP were re-evaluated after a mean period of 10.5 years of supportive periodontal therapy (SPT). Two thousand and fifty-four teeth were entered into the model. The tooth-related factors including baseline bone loss, tooth location and type, furcation involvement (FI), regenerative therapy, and abutment status, as well as time of follow-up and other patient-related factors were tested for their prognostic value at tooth level. Multilevel regression analysis was performed for statistical analysis to identify factors contributing to tooth loss. RESULTS During SPT, 113 teeth (1.34 teeth per patient) were lost. Baseline bone loss, use as abutment tooth, tooth type, and maxillary location contributed significantly to tooth loss during SPT. Molars showed the highest risk for tooth loss after APT. Moreover, time of follow-up and the patient-related factor "educational status" significantly accounted for tooth loss at tooth level. CONCLUSION Baseline bone loss, abutment status, tooth location, and type as well as time of follow-up and educational status were detected as prognostic factors for tooth loss during SPT in patients with AgP at tooth level.
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Affiliation(s)
- Amelie Bäumer
- Section of Periodontology, Department of Conservative Dentistry Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany.
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Ozcelik O, Haytac MC, Seydaoglu G. Treatment of multiple gingival recessions using a coronally advanced flap procedure combined with button application. J Clin Periodontol 2011; 38:572-80. [DOI: 10.1111/j.1600-051x.2011.01724.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Ng MCH, Ong MMA, Lim LP, Koh CG, Chan YH. Tooth loss in compliant and non-compliant periodontally treated patients: 7 years after active periodontal therapy. J Clin Periodontol 2011; 38:499-508. [PMID: 21342213 DOI: 10.1111/j.1600-051x.2011.01708.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To investigate the incidence and reasons for tooth loss during active periodontal therapy (APT) and periodontal maintenance (PM) in a specialist institution. MATERIAL AND METHODS Retrospective data were collected from 273 patients [all compliers (AC)] and cross-sectional data from 39 patients after discontinuation of PM [non-compliers (NC)] for at least 7 years after APT. Descriptive statistics and regression analysis were performed. A comparison was made between AC and NC. The prognostic factors associated with tooth loss during PM were identified. RESULTS AC lost 1.3 teeth/patient during APT and 0.9 teeth/patient during PM (mean 10.7 years). Tooth loss due to periodontitis was 0.03 teeth/patient/year. The age of 60 was a significant predictor of tooth loss during PM (odds ratio of 2.1). NC lost 1.1 teeth/patient during APT and 2.7 teeth/patient during discontinuation (mean 9.6 years). Tooth loss due to periodontitis was 0.22 teeth/patient/year, a sevenfold increase (p<0.05) compared with AC. Regression analysis failed to identify any significant predictors for tooth loss during the discontinuation of PM. CONCLUSIONS In this study, the provision of PM led to minimal tooth loss, especially due to periodontitis, for a mean period of 10 years after APT. The completion of APT without PM may predispose patients to lose more teeth compared with patients who undergo PM.
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Affiliation(s)
- Mervyn Cher-Hui Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore.
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Bäumer A, El Sayed N, Kim TS, Reitmeir P, Eickholz P, Pretzl B. Patient-related risk factors for tooth loss in aggressive periodontitis after active periodontal therapy. J Clin Periodontol 2011; 38:347-54. [PMID: 21284688 DOI: 10.1111/j.1600-051x.2011.01698.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Evaluation of patient-related risk factors contributing to tooth loss and recurrence of periodontitis 10.5 years after initial therapy in patients with aggressive periodontitis (AgP). MATERIAL AND METHODS Eighty-four of 174 patients were included. Re-examination consisted of patient's history, clinical examination and test for interleukin (IL)-1 composite genotype. Patients' charts were searched for regularity of maintenance and initial diagnosis. Statistical analysis was performed using Poisson and logistical regression analysis. RESULTS The responder rate was 48%. Thirteen of 84 patients presented a localized AgP, 68 were females and 29 smoked. One hundred and thirteen teeth out of 2154 were lost after therapy (1.34 teeth/patient). Age (p=0.0018), absence of IL-1 composite genotype (p=0.0091) and educational status (p=0.0085) were identified as statistically significant risk factors for tooth loss. Twenty patients exhibited recurrence of periodontitis at re-examination. Smoking (p=0.0034) and mean Gingival Bleeding Index (GBI) (p=0.0239) contributed significantly to recurrence of disease. No patient participating regularly in supportive periodontal therapy (SPT) showed disease recurrence. CONCLUSION Age, absence of IL-1 composite genotype and low social status are detected as risk factors for tooth loss. Smoking and high mean GBI are associated with an increased risk for recurrence of periodontitis, whereas regular SPT acts as a protective factor.
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Affiliation(s)
- Amelie Bäumer
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany.
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Zitzmann NU, Scherrer SS, Weiger R, Lang NP, Walter C. Preferences of dental care providers in maintaining compromised teeth in relation to their professional status: implants instead of periodontally involved maxillary molars? Clin Oral Implants Res 2010; 22:143-50. [DOI: 10.1111/j.1600-0501.2010.02062.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sarfati A, Bourgeois D, Katsahian S, Mora F, Bouchard P. Risk Assessment for Buccal Gingival Recession Defects in an Adult Population. J Periodontol 2010; 81:1419-25. [PMID: 20476890 DOI: 10.1902/jop.2010.100102] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Alexandre Sarfati
- Department of Periodontology, Service of Odontology, Hôtel-Dieu Hospital, Public Health - Paris Hospitals, Paris 7 – Denis Diderot University, Formation and Research Unit of Odontology, Paris, France.
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Kerner S, Sarfati A, Katsahian S, Jaumet V, Micheau C, Mora F, Monnet-Corti V, Bouchard P. Qualitative cosmetic evaluation after root-coverage procedures. J Periodontol 2009; 80:41-7. [PMID: 19228088 DOI: 10.1902/jop.2009.080413] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND The purpose of the present study was to evaluate the esthetic outcome using four categories of root-coverage procedures (pedicle soft tissue grafts, non-submerged grafts, submerged grafts, and envelope techniques) and to identify factors associated with esthetic assessment. METHODS A professional panel of three observers (two periodontists and one control) used a before-after panel scoring system to evaluate the esthetics of 162 root-coverage surgeries. A five-point ordinal scale was used to evaluate the overall esthetic improvement and seven variables that may be considered in the assessment. RESULTS The intraobserver agreement of the two trained periodontists for the overall cosmetic assessment was almost perfect (kappa = 0.83), and substantial agreement was found between them (kappa = 0.68). Good to excellent overall esthetic results were found by the professionals and control in >70% of the surgical procedures. Analysis of variance indicated a statistical difference between the non-submerged grafts category and the three other surgical categories (P <10(-3)). Multivariate analysis showed that the degree of root coverage was not a significant predictive factor, whereas soft tissue appearance variables and the follow-up were significantly associated with cosmetic assessment. CONCLUSIONS The present study demonstrated that non-submerged grafts are not recommended in cases of esthetic demand. Future root-coverage trials, basing their justification on esthetics, should include overall qualitative evaluation as the primary variable. The follow-up period should not be <12 months. The before-after panel scoring system is a tool that can be used to evaluate cosmetic outcomes.
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Affiliation(s)
- Stéphane Kerner
- Department of Periodontology, Service of Odontology, Hôtel-Dieu Hospital, AP-HP, Paris 7-Denis Diderot University, UFR of Odontology, Paris, France
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Rotundo R, Nieri M, Mori M, Clauser C, Pini Prato G. Aesthetic perception after root coverage procedure. J Clin Periodontol 2008; 35:705-12. [DOI: 10.1111/j.1600-051x.2008.01244.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Kerner S, Borghetti A, Katsahian S, Etienne D, Malet J, Mora F, Monnet-Corti V, Glise JM, Bouchard P. A Retrospective study of root coverage procedures using an image analysis system. J Clin Periodontol 2008; 35:346-55. [DOI: 10.1111/j.1600-051x.2008.01204.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Andrade PF, Felipe MEMC, Novaes AB, Souza SLS, Taba M, Palioto DB, Grisi MFM. Comparison between two surgical techniques for root coverage with an acellular dermal matrix graft. J Clin Periodontol 2008; 35:263-9. [DOI: 10.1111/j.1600-051x.2007.01193.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Eickholz P, Kaltschmitt J, Berbig J, Reitmeir P, Pretzl B. Tooth loss after active periodontal therapy. 1: patient-related factors for risk, prognosis, and quality of outcome. J Clin Periodontol 2008; 35:165-74. [DOI: 10.1111/j.1600-051x.2007.01184.x] [Citation(s) in RCA: 191] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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