1
|
Malhotra S, Tewari S, Sharma R, Sharma RK, Tanwar N, Arora R. Clinical evaluation of root coverage in Miller class III/RT2 labial gingival recession treated with interdisciplinary periodontal-orthodontic therapy: a randomized controlled clinical trial. J Periodontal Implant Sci 2024; 54:265-279. [PMID: 38290996 DOI: 10.5051/jpis.2204100205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 03/21/2023] [Accepted: 04/30/2023] [Indexed: 02/01/2024] Open
Abstract
PURPOSE The aim of current study was to evaluate percentage root coverage (RC%) in isolated Miller class III/RT2 labial gingival recession (GR) associated with malaligned mandibular anteriors, using interdisciplinary periodontal-orthodontic treatment as compared to mucogingival surgery alone. METHODS Thirty-six systemically healthy patients having isolated Miller class III/RT2 GR with respect to malaligned mandibular anteriors, were randomly divided into test group: mucogingival surgery using subepithelial connective tissue graft followed by orthodontic treatment and control group: mucogingival surgery alone. Primary clinical parameters included (RC%), recession depth, keratinized tissue width, mid-labial clinical attachment level, interdental clinical attachment level (iCAL), periodontal phenotype (PP), gingival thickness (GT), root coverage esthetics score (RES) and hypersensitivity. Total duration of follow up was 12 months. RESULTS Mean RC% was significantly more achieved in test group (66.67%±40.82%) in comparison to control group (39.93%±31.41%) at the end of study (P=0.049). Further, complete root coverage was attained in 5/8 cases of test group versus 1/2 cases of control group after 3/12 months respectively. RES and hypersensitivity, showed statistically significant improvement after complete follow up period in both the groups. An ideal RES score of 10 was achieved in 4/7 cases of test group while in 1/2 cases of control group after 3/12 months respectively. Correlation analysis revealed significant negative correlation between RC% and iCAL. Correlation of RC% with GT and PP was non-significant. CONCLUSIONS Interdisciplinary periodontal-orthodontic approach may be more beneficial in terms of achieving improved RC%, esthetic and resolution of hypersensitivity in the management of Miller class III/RT2 GR in malaligned mandibular anteriors. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04255914.
Collapse
Affiliation(s)
- Sakshi Malhotra
- Department of Periodontics, Post Graduate Institute of Dental Sciences, Rohtak, India
| | - Shikha Tewari
- Department of Periodontics, Post Graduate Institute of Dental Sciences, Rohtak, India.
| | - Rekha Sharma
- Department of Orthodontics and Dentofacial Orthopaedics, Post Graduate Institute of Dental Sciences, Rohtak, India
| | - Rajinder Kumar Sharma
- Department of Periodontics, Post Graduate Institute of Dental Sciences, Rohtak, India
| | - Nishi Tanwar
- Department of Periodontics, Post Graduate Institute of Dental Sciences, Rohtak, India
| | - Ritika Arora
- Department of Periodontics, Post Graduate Institute of Dental Sciences, Rohtak, India
| |
Collapse
|
2
|
Mallappa J, Patil L, Mani AD, Gowda TM. Novel biomaterial advanced platelet-rich fibrin plus block for multiple gingival recession. Clin Adv Periodontics 2024; 14:63-69. [PMID: 37417683 DOI: 10.1002/cap.10257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/15/2023] [Accepted: 07/04/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND The study was aimed to assess and compare hard and soft tissue augmentation clinicoradiographically with and without advanced platelet-rich fibrin + (A-PRF+) block for the treatment of multiple gingival recession using vestibular incision subperiosteal tunnel access (VISTA). METHODS A total of 24 patients, exhibiting multiple Miller's Class I or II recessions in the maxillary esthetic zone were included. Participants were divided into two groups, Group 1 was treated with VISTA & A-PRF+ block whereas Group 2 was with VISTA technique alone. Clinical parameters probing depth, width of keratinized gingiva, gingival biotype, recession depth, and clinical attachment level were recorded at baseline and the end of 6 months. The radiographic cone beam computed tomography measurements of labial plate thickness were taken at baseline and 6 months postoperatively. RESULTS From baseline to 6 months both the groups showed a clinical and statistical improvement in the parameters. However, a statistically significant difference between the treatment modalities was not observed. In the inter-group comparison radiographically, labial plate thickness was statistically significant at the end of 6 months when compared to the baseline. CONCLUSION A-PRF+ block along with the VISTA technique can be an alternative effective root coverage procedure for the management of multiple gingival recessions in the maxillary esthetic zone. KEY POINTS Why is this study new information? To the best of our knowledge, this is the first study using advanced platelet-rich fibrin plus block for the treatment of multiple gingival recession with a thin labial plate. What are the keys to the successful management of these types of cases? Minimally invasive vestibular incision subperiosteal tunnel access technique, and avoidance of second surgical site morbidity are important factors for treatment and for patient compliance. What are the primary limitations of this study? Short study duration, small sample size, and no histological correlation can be considered as limitations of the study.
Collapse
Affiliation(s)
- Jayasheela Mallappa
- Department Of Periodontics, Bapuji Dental College And Hospital, Davangere, India
| | - Leena Patil
- Department Of Periodontics, Bapuji Dental College And Hospital, Davangere, India
| | - Adi Deepika Mani
- Department Of Periodontics, Bapuji Dental College And Hospital, Davangere, India
| | - Triveni M Gowda
- Department Of Periodontics, Bapuji Dental College And Hospital, Davangere, India
| |
Collapse
|
3
|
Patra L, Raj SC, Katti N, Mohanty D, Pradhan SS, Tabassum S, Mishra AK, Patnaik K, Mahapatra A. Comparative evaluation of effect of injectable platelet-rich fibrin with collagen membrane compared with collagen membrane alone for gingival recession coverage. World J Exp Med 2022; 12:68-91. [PMID: 36157336 PMCID: PMC9350719 DOI: 10.5493/wjem.v12.i4.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 04/26/2022] [Accepted: 06/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Collagen membrane and platelet-rich fibrin (PRF) have emerged as vital biomaterials in the field of periodontal regeneration. Minimally invasive techniques are being preferred by most periodontists, as it is patient compliant with fewer post-surgical complications as compared to conventional surgical techniques. Thus, in this study we have evaluated the effect of injectable PRF (i-PRF) with collagen membrane compared with collagen membrane alone using vestibular incision subperiosteal tunnel access (VISTA) technique for gingival recession coverage.
AIM To compare the efficacy of VISTA using collagen membrane with collagen membrane soaked in injectable PRF for gingival recession coverage.
METHODS A split mouth randomized controlled clinical trial was designed;13 subjects having at least 2 teeth indicated for recession coverage were enrolled in this study. The sites were randomly assigned to control group (VISTA using collagen membrane alone) and the test group (VISTA using collagen membrane with i-PRF). The clinical parameters assessed were pocket depth, recession depth (RD), recession width (RW), relative attachment level, keratinised tissue width (KTW), keratinised tissue thickness (KTT), and percentage root coverage.
RESULTS RD showed a statistically significant difference between the test group at 3 mo (0.5 ± 0.513) and 6 mo (0.9 ± 0.641) and the control group at 3 mo (0.95 ± 0.51) and 6 mo (1.5 ± 0.571), with P values of 0.008 and 0.04, respectively. RW also showed a statistically significant difference between the test group at 3 mo (1 ± 1.026) and 6 mo (1.65 ± 1.04) and the control group at 3 mo (1.85 ± 0.875) and 6 mo (2.25 ± 0.759), with P values of 0.008 and 0.001, respectively. Results for KTW showed statistically significant results between the test group at 1 mo (2.85 ± 0.489), 3 mo (3.5 ± 0.513), and 6 mo (3.4 ± 0.598) and the control group at 1 mo (2.45 ± 0.605), 3 mo (2.9 ± 0.447), and 6 mo (2.75 ± 0.444), with P values of 0.04, 0.004, and 0.003, respectively. Results for KTT also showed statistically significant results between test group at 1 mo (2.69 ± 0.233), 3 mo (2.53 ± 0.212), and 6 mo (2.46 ± 0.252) and the control group at 1 mo (2.12 ± 0.193), 3 mo (2.02 ± 0.18), and 6 mo (1.91 ± 0.166), with P values of 0.001, 0.001, and 0.001, respectively. The test group showed 91.6%, 81.6%, and 67% root coverage at 1 mo, 3 mo, and 6 mo, while the control group showed 82.3%, 66.4%, and 53.95% of root coverage at 1 mo, 3 mo, and 6 mo, respectively.
CONCLUSION The use of minimally invasive VISTA technique along with collagen membrane and injectable form of platelet-rich fibrin can be successfully used as a treatment method for multiple or isolated gingival recessions of Miller’s class-I and class-II defects.
Collapse
Affiliation(s)
- Laxmikanta Patra
- Department of Periodontics, SCB Dental College and Hospital, Odisha 753007, India
| | - Subash Chandra Raj
- Department of Periodontics, SCB Dental College and Hospital, Odisha 753007, India
| | - Neelima Katti
- Department of Periodontics, SCB Dental College and Hospital, Odisha 753007, India
| | - Devapratim Mohanty
- Department of Periodontics, SCB Dental College and Hospital, Odisha 753007, India
| | - Shib Shankar Pradhan
- Department of Periodontics, SCB Dental College and Hospital, Odisha 753007, India
| | - Shaheda Tabassum
- Department of Periodontics, SCB Dental College and Hospital, Odisha 753007, India
| | - Asit Kumar Mishra
- Department of Periodontics, SCB Dental College and Hospital, Odisha 753007, India
| | - Kaushik Patnaik
- Department of Periodontics, SCB Dental College and Hospital, Odisha 753007, India
| | - Annuroopa Mahapatra
- Department of Periodontics, SCB Dental College and Hospital, Odisha 753007, India
| |
Collapse
|
4
|
Jain KS, Vaish S, Gupta SJ, Sharma N, Khare M, Nair MM. Minimally invasive treatment of gingival recession by vestibular incision subperiosteal tunnel access technique with collagen membrane and advanced platelet-rich fibrin: A 6-month comparative clinical study. J Indian Soc Periodontol 2021; 25:496-503. [PMID: 34898915 PMCID: PMC8603801 DOI: 10.4103/jisp.jisp_590_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 05/08/2021] [Accepted: 05/09/2021] [Indexed: 11/24/2022] Open
Abstract
AIM The study aimed to assess the minimally invasive Vestibular Incision Subperiosteal Tunnel Access (VISTA) technique for treatment of Millers Class I or Class II buccal gingival recession defects and to compare the effectiveness of a bioresorbable collagen membrane or advanced platelet rich fibrin (A-PRF). METHODS AND MATERIAL 20 sites with Millers Class I or II gingival recession were recruited and allocated into 2 groups with 10 sites each. Group 1: VISTA with A-PRF, Group 2: VISTA with with bioresorbable collagen membrane (Healiguide)®. STANDARDIZED CLINICAL PARAMETERS Plaque Index (PI), Gingival Index (GI), Clinical attachment level (CAL )Pocket Probing Depth (PPD) Recession Height (RH ) and width of keratinized gingiva (WKG) were measured at baseline 3 months and 6 months. RESULTS Both groups showed significant improvement in clinical parameters. However reduction in recession height and mean root coverage percentage was greater in A-PRF group after 6 months. CONCLUSIONS VISTA with both A-PRF and Healiguide showed good clinical outcomes but better results were obtained when A-PRF was used.
Collapse
Affiliation(s)
- Kavya Sangal Jain
- Department of Periodontology and Oral Implantology, ITS-Centre for Dental Studies and Research Center, Ghaziabad, Uttar Pradesh, India
| | - Shubhra Vaish
- Department of Periodontology and Oral Implantology, ITS-Centre for Dental Studies and Research Center, Ghaziabad, Uttar Pradesh, India
| | - Swyeta Jain Gupta
- Department of Periodontology and Oral Implantology, ITS-Centre for Dental Studies and Research Center, Ghaziabad, Uttar Pradesh, India
| | - Nikhil Sharma
- Department of Periodontology and Oral Implantology, ITS-Centre for Dental Studies and Research Center, Ghaziabad, Uttar Pradesh, India
| | - Medhavee Khare
- Department of Periodontology and Oral Implantology, ITS-Centre for Dental Studies and Research Center, Ghaziabad, Uttar Pradesh, India
| | - Meera M. Nair
- Department of Periodontology and Oral Implantology, ITS-Centre for Dental Studies and Research Center, Ghaziabad, Uttar Pradesh, India
| |
Collapse
|
5
|
Kamal A, Abdel Meguid Moustafa A, Abdallah Khalil A. Treatment of Gingival Recession Class II Defect using Buccal Fat Pad versus Platelet Rich Fibrin using Vestibular Incision Subperiosteal Tunnel Access Technique. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
ABSTRACTAim of study: The aim of this study was to Compare the effectiveness of Non-pedicled buccal fat pad versus Platelet rich fibrin in treatment of Miller class II gingival recession using vistubular Incision Subperiosteal Tunnel Access TechniquePatients and methods:This study was conducted on 40 patients with class II gingival recession in anterior or premolar segment. The entire patients were selected from the out patient clinic of the Oral Medicine, Oral Diagnosis, and Periodontology Department. Faculty of Dentistry, Minya University.Forty patients with gingival recession class II were divided randomly into two groups:Group I: (20 defect) using VISTA technique with Non- pedicled buccal fat pad (NPBFP), Group II: (20 defect) using VISTA technique with platelet rich fibrin (PRF).Results: In both groups all clinical parameters were statistically significant from pre-operative period till 6 months follow up period. In the comparison between the two groups after 6 months follow up period, there were no statistically significant difference between two groups regarding all clinical parameters except percentage of root coverage; there was significant increase in percentage of root coverage after 3 and 6 months follow up period in group II with p value was less than 0.05.Conclusion: Both PRF membrane and NPBFP are effective in the management of Class II gingival recession defects using VISTA technique. PRF group has better results regarding percentage of root coverage than NPBPF group after 3 and 6 months follow up.
Collapse
|
6
|
Hegde S, Madhurkar JG, Kashyap R, Kumar MSA, Boloor V. Comparative evaluation of vestibular incision subperiosteal tunnel access with platelet-rich fibrin and connective tissue graft in the management of multiple gingival recession defects: A randomized clinical study. J Indian Soc Periodontol 2021; 25:228-236. [PMID: 34158690 PMCID: PMC8177182 DOI: 10.4103/jisp.jisp_291_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 12/19/2020] [Accepted: 01/26/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The etiology of gingival recession is often multifactorial. Wide array of surgical techniques are available to manage gingival recession. The aim of the present study was to compare, minimally invasive approach (vestibular incision subperiosteal tunnel access [VISTA]), in combination with platelet-rich fibrin (PRF) and connective tissue graft (CTG) in the management of multiple recession defects in maxillary anterior region. MATERIALS AND METHODS A total of 32 sites from 10 systemically healthy controls were allocated randomly to VISTA with PRF (VISTA + PRF) and VISTA with CTG (VISTA + CTG). Plaque index, gingival index, Probing probing pocket depth (PPD), relative attachment level (RAL), recession depth (RD), recession width (RW), width of keratinized gingiva (WKG), and percentage of root coverage (%RC) were calculated at 6 months postoperatively. RESULTS Results showed significant improvement in mean PPD, RAL, RD, RW, and KTW. %RC in VISTA + PRF and VISTA + CTG was 83.25% ± 25.02% and 86.43% ± 22.79%, respectively, at 6 months. There were no significant differences in the parameters between the VISTA + PRF and VISTA + CTG groups. CONCLUSION VISTA is a minimally invasive surgical approach, which can be combined with CTG or PRF in the management of Miller's Class I and Class II recession defects, with predictable outcomes. There were significant improvements in the clinical parameters from baseline to 6 months in both the groups. To match with the CTG, which is the gold standard procedure, PRF can be used as an alternative for treating multiple recession defects.
Collapse
Affiliation(s)
- Shashikanth Hegde
- Department of Periodontology, Yenepoya Dental College, Yenepoya (Deemed to be) University, Deralakatte, Mangalore, Karnataka, India
| | - Jyosthna Ganapathi Madhurkar
- Department of Periodontology, Yenepoya Dental College, Yenepoya (Deemed to be) University, Deralakatte, Mangalore, Karnataka, India
| | - Rajesh Kashyap
- Department of Periodontology, Yenepoya Dental College, Yenepoya (Deemed to be) University, Deralakatte, Mangalore, Karnataka, India
| | - Maiya S Arun Kumar
- Department of Periodontology, Yenepoya Dental College, Yenepoya (Deemed to be) University, Deralakatte, Mangalore, Karnataka, India
| | - Vinita Boloor
- Department of Periodontology, Yenepoya Dental College, Yenepoya (Deemed to be) University, Deralakatte, Mangalore, Karnataka, India
| |
Collapse
|
7
|
Fernández-Jiménez A, García-De-La-Fuente AM, Estefanía-Fresco R, Marichalar-Mendia X, Aguirre-Urizar JM, Aguirre-Zorzano LA. Complete root coverage in the treatment of Miller class III or RT2 gingival recessions: a systematic review and meta-analysis. BMC Oral Health 2021; 21:145. [PMID: 33752657 PMCID: PMC7986294 DOI: 10.1186/s12903-021-01494-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/07/2021] [Indexed: 11/22/2022] Open
Abstract
Background The primary objective of this systematic review and meta-analysis was to assess the evidence on complete root coverage (CRC) achieved by periodontal plastic techniques in the treatment of Miller class III/RT2 gingival recessions, comparing techniques developed along the twentieth century (pre-twenty-first) versus surgical approaches of the twenty-first century (21st). Methods An electronic bibliographic search was carried out in four databases up to December 2019, focusing on studies that reported CRC results in Miller class III or RT2 recessions treatment with at least a six-month follow-up. In addition, a random-effects models’ meta-analysis was performed for the CRC, comparing pre-twenty-first versus twenty-first century techniques at 6 months, 12 months and more than 12 months. Results Thirty-seven publications were included. A total of 933 gingival recessions were treated, 298 with pre-twenty-first century surgical techniques and 635 with techniques from the twenty-first century. CRC was achieved at 6 months on half of the recessions (pre-twenty-first: 57.60% vs. 21st: 51.11%), but decreased markedly for twenty-first century techniques at 12 months (pre-twenty-first: 63.82% vs. 21st: 32.87%). Thereafter, this difference was the other way around (> 12 months: pre-twenty-first: 5.26% vs. 21st: 19.65%). The meta-analysis showed a high heterogeneity, with no significant differences amongst the techniques. Conclusions Although CRC might be achievable by treating Miller class III or RT2 recessions with any of the described techniques, its long-term stability is not predictable. More randomized clinical trials with longer follow-ups and several visits, are needed. In addition, the patient’s satisfaction should also be assessed. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01494-3.
Collapse
Affiliation(s)
- Aitziber Fernández-Jiménez
- Department of Stomatology II, University of the Basque Country (UPV/EHU), UPV/EHU. Barrio Sarriena S/N, 48940, Leioa, Biscay, Spain
| | - Ana-María García-De-La-Fuente
- Department of Stomatology II, University of the Basque Country (UPV/EHU), UPV/EHU. Barrio Sarriena S/N, 48940, Leioa, Biscay, Spain.
| | - Ruth Estefanía-Fresco
- Department of Stomatology II, University of the Basque Country (UPV/EHU), UPV/EHU. Barrio Sarriena S/N, 48940, Leioa, Biscay, Spain
| | - Xabier Marichalar-Mendia
- Department of Nursing I, University of the Basque Country (UPV/EHU), Barrio Sarriena S/N, 48940, Leioa, Biscay, Spain
| | - José-Manuel Aguirre-Urizar
- Department of Stomatology II, University of the Basque Country (UPV/EHU), UPV/EHU. Barrio Sarriena S/N, 48940, Leioa, Biscay, Spain
| | - Luis-Antonio Aguirre-Zorzano
- Department of Stomatology II, University of the Basque Country (UPV/EHU), UPV/EHU. Barrio Sarriena S/N, 48940, Leioa, Biscay, Spain
| |
Collapse
|
8
|
Subbareddy BV, Gautami PS, Dwarakanath CD, Devi PK, Bhavana P, Radharani K. Vestibular Incision Subperiosteal Tunnel Access Technique with Platelet-Rich Fibrin Compared to Subepithelial Connective Tissue Graft for the Treatment of Multiple Gingival Recessions: A Randomized Controlled Clinical Trial. Contemp Clin Dent 2020; 11:249-255. [PMID: 33776351 PMCID: PMC7989760 DOI: 10.4103/ccd.ccd_405_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 04/16/2020] [Accepted: 05/28/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The aim of this study was to compare the effectiveness of root coverage through vestibular incision subperiosteal tunnel access (VISTA) technique using platelet rich fibrin (PRF) or subepithelial connective tissue graft (SCTG) in multiple gingival recessions. MATERIALS AND METHODS A total of 20 patients with multiple gingival recessions were included, and 10 subjects were randomly allocated to test group (VISTA with PRF) and 10 patients to control group (VISTA with SCTG). Clinical parameters were recorded at baseline, 3 months, and 6 months. Patient's response toward the treatment was also assessed by questionnaire. RESULTS All the clinical parameters in the study have showed better results in test group when compared to control group after a follow up period of 6 months with statistical significance. CONCLUSION The results of the present study suggested that multiple gingival recessions can be successfully treated with both procedures, but better root coverage and a greater increase in keratinized tissue were achieved with the VISTA technique with SCTG. All the patients in both groups felt it was worth undergoing the treatment.
Collapse
Affiliation(s)
| | - Penmetsa S. Gautami
- Department of Periodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - C. D. Dwarakanath
- Department of Periodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Panda Kausalya Devi
- Department of Periodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Parimisetti Bhavana
- Department of Periodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - K. Radharani
- Department of Periodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| |
Collapse
|
9
|
Zadeh HH, Borzabadi-Farahani A, Fotovat M, Kim SH. Vestibular Incision Subperiosteal Tunnel Access (VISTA) for Surgically Facilitated Orthodontic Therapy (SFOT). Contemp Clin Dent 2020; 10:548-553. [PMID: 32308335 PMCID: PMC7150560 DOI: 10.4103/ccd.ccd_720_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Surgically Facilitated Orthodontic Therapy (SFOT) in combination with bone augmentation and the placement of anchorage devices installed into bone have been used to accelerate and facilitate orthodontic treatment. This is usually performed after flap surgery, which is associated with moderate morbidity, as well as possible negative sequale such as gingival recession. The present case report illustrates the clinical benefits of vestibular incision subperiosteal tunnel access (VISTA) for SFOT, and tissue augmentation to facilitate orthodontic therapy. VISTA entails making vertical incision(s) in the vestibule followed by subperiosteal elevation of tunnels to provide direct access to the facial alveolar bone. Unlike previously reported vestibular access surgical procedures, VISTA allows for wider elevation of an access tunnel for clear visual and surgical access to perform careful inter-radicular corticotomy. The present report describes VISTA for corticotomy surgery (anterior mandible and maxillary teeth) in combination with the placement of titanium fixation devices and bone augmentation to facilitate orthodontic treatment of an adult female with borderline Class II Division 1 malocclusion, with excessive overjet and deepbite. In view of the fact that VISTA does not require surface incisions in the gingival margins or papillae, it potentially minimizes gingival recession that sometimes accompanies flap surgery.
Collapse
Affiliation(s)
- Homayoun H Zadeh
- VISTA Institute for Therapeutic Innovations, Woodland Hills, CA, USA
| | - Ali Borzabadi-Farahani
- Department of Clinical Sciences and Translational Medicine, University of Rome, Rome, Italy.,Department of Orthodontics, Finchley Orthodontics, North Finchley, London, UK
| | - Mehdi Fotovat
- Private Practice Limited to Orthodontics, Valley Village, CA, USA
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| |
Collapse
|
10
|
Grecu AF, Reclaru L, Ardelean LC, Nica O, Ciucă EM, Ciurea ME. Platelet-Rich Fibrin and its Emerging Therapeutic Benefits for Musculoskeletal Injury Treatment. ACTA ACUST UNITED AC 2019; 55:medicina55050141. [PMID: 31096718 PMCID: PMC6572609 DOI: 10.3390/medicina55050141] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/21/2019] [Accepted: 04/23/2019] [Indexed: 12/12/2022]
Abstract
New therapies that accelerate musculoskeletal tissue recovery are highly desirable. Platelet-rich fibrin (PRF) is a leukocyte- and platelet-rich fibrin biomaterial that acts as a binding site for both platelets and growth factors. Through increasing the local concentration of growth factors at specific tissues, PRF promotes tissue regeneration. PRF has been frequently used in combination with bone graft materials to reduce healing times and promote bone regeneration during maxillofacial surgery. However, its benefits during muscle repair and recovery are less well-documented. Here, we perform a narrative review on PRF therapies and muscle injuries to ascertain its beneficial effects. We reviewed the factors that contribute to the biological activity of PRF and the published pre-clinical and clinical evidence to support its emerging use in musculoskeletal therapy. We include in vitro studies, in vivo animal studies and clinical articles highlighting both the success and failures of PRF treatment. PRF can promote the healing process when used in a range of orthopaedic and sports-related injuries. These include cartilage repair, rotator cuff surgery and anterior cruciate ligament surgery. However, conflicting data for these benefits have been reported, most likely due to inconsistencies in both PRF preparation protocols and dosing regimens. Despite this, the literature generally supports the use of PRF as a beneficial adjuvant for a range of chronic muscle, tendon, bone or other soft tissue injuries. Further clinical trials to confirm these benefits require consistency in PRF preparation and the classification of a successful clinical outcome to fully harness its potential.
Collapse
Affiliation(s)
- Alexandru Florian Grecu
- PhD Researcher - University of Medicine and Pharmacy Craiova, str. Petru Rares no.2, 200349, Craiova, Romania.
| | - Lucien Reclaru
- Varinor Matériaux SA, 7 St-Georges str, CH 2800, Delémont, Switzerland.
| | - Lavinia Cosmina Ardelean
- "Victor Babes" University of Medicine and Pharmacy from Timisoara, Dept. of Technology of Materials and 9 Devices in Dental Medicine,2 Eftimie Murgu sq, 300041 Timisoara, Romania.
| | - Oliviu Nica
- PhD Researcher - University of Medicine and Pharmacy Craiova, str. Petru Rares no.2, 200349, Craiova, Romania.
| | - Eduard Mihai Ciucă
- Department of Oro-Maxilo-Facial Surgery ⁻ University of Medicine and Pharmacy Craiova, str. Petru Rares, no.2, 200349 Craiova, Romania.
| | - Marius Eugen Ciurea
- Department of Plastic Surgery - University of Medicine and Pharmacy of Craiova, str. Petru Rares, no.2, 200349 Craiova, Romania.
| |
Collapse
|
11
|
Fan KA, Zhong JS, Ouyang XY, Xie Y, Chen ZY, Zhou SY, Zhang Y. [Vestibular incision subperiosteal tunnel access with connective tissue graft for the treatment of Miller classI and II gingival recession]. JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2019; 51:80-85. [PMID: 30773549 DOI: 10.19723/j.issn.1671-167x.2019.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the clinical outcomes of vestibular incision subperiosteal tunnel access (VISTA) with connective tissue graft (CTG) in the treatment of Miller classes I and II localized gingival recession. METHODS Ten patients with 10 Miller classes I and II localized gingival recessions were enrolled in the study. All defects were equal to or above 2 mm in recession depth. All the patients received treatment with VISTA+CTG. Their clinical parameters, including recession depth (Rec), recession width (RW), keratinized tissue width (KT), clinical attachment loss (CAL), probing depth (PD) were recorded and compared before surgery and 6 months later. The mean root coverage (MRC) and complete root coverage (CRC) were calculated at the end of 6 months. A visual analogue scale (VAS) was used to estimate the patients' discomfort during the operation and during the 2 weeks post-operation. Patient-based aesthetic satisfaction 6 months after surgery was evaluated by a VAS. RESULTS The mean Rec was (2.65±0.82) mm at baseline, and (0.35±0.58) mm after 6 months. The VISTA+CTG treatment resulted in an improvement of (2.30±0.98) mm in recession depth (P<0.001). MRC was 86.67%±21.94% and CRC reached 70% at the end of 6 months. KT increased (0.90±1.22) mm (P<0.05). Aesthetic satisfaction on the patients' level was 8.30 based on VAS (0=unsatisfied, 10=extremely satisfied). The patients' discomfort during the operation and 2 weeks post operation were 2.40 and 4.30 (0=no pain, 10=extreme pain). Furthermore, clinical outcomes showed no statistically significant difference between the gingival biotypes, and between the teeth positioned in maxillary and in mandibular. CONCLUSION VISTA+CTG could be an effective treatment for Miller classes I and II localized gingival recession. Clinical outcomes indicated decrease in recession depth and width, and increase in width of keratinized tissue. Patients suffered little pain during the operation and 2 weeks post-operation of healing and accessed good aesthetic satisfaction. VISTA+CTG could be an option for the treatment of Miller classes I and II localized gingival recession.
Collapse
Affiliation(s)
- K A Fan
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - J S Zhong
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - X Y Ouyang
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Y Xie
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Z Y Chen
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - S Y Zhou
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Y Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| |
Collapse
|