Comparison of pedicle and connective tissue grafts for gingival recession.

| Posted in: Science

Journal name: Journal of Indian Society of Periodontology
Original article title: Comparative clinical evaluation of laterally positioned pedicle graft and subepithelial connective tissue graft in the treatment of Miller's Class I and II gingival recession: A 6 months study
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:

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Author:

Kirti Satish Dulani, Neeta Vijay Bhavsar, Sakshee Rahul Trivedi, Rahul Anil Trivedi


Journal of Indian Society of Periodontology:

(A bimonthly open-access journal)

Full text available for: Comparative clinical evaluation of laterally positioned pedicle graft and subepithelial connective tissue graft in the treatment of Miller's Class I and II gingival recession: A 6 months study

Year: 2015 | Doi: 10.4103/0972-124X.164762

Copyright (license): CC BY-NC-SA


Summary of article contents:

Introduction

The aim of the study was to compare the clinical outcomes of laterally positioned pedicle graft (LPPG) and subepithelial connective tissue graft (SCTG) in treating Miller's Class I and II gingival recession defects over a six-month period. Gingival recession is a condition that can lead to aesthetic concerns, dentinal hypersensitivity, and increased susceptibility to root caries. Various mucogingival procedures exist to address these issues, but the effectiveness of LPPG and SCTG provides insight into patient management and treatment choices. This clinical, randomized control trial included sixty defects from patients presenting with gingival recession, assessing key parameters such as recession depth, width of keratinized gingiva, percentage of root coverage, and complete root coverage postoperatively.

Efficacy of Treatment Approaches

One significant finding of the study was the difference in effectiveness between the two grafting techniques. Statistical analysis demonstrated that while both LPPG and SCTG significantly reduced recession depth and improved width of keratinized gingiva at six months, SCTG yielded better results in both percentage of root coverage (88.33%) and complete root coverage (63.33%), compared to LPPG. The mean reduction of recession depth in LPPG was 3.8 mm, while SCTG achieved a reduction of 4.2 mm. These outcomes suggest that SCTG is particularly effective in not only addressing recession in various defect configurations but also in better managing patient expectations for aesthetic outcomes.

Conclusion

Both LPPG and SCTG significantly improved the aesthetic appearance of patients with gingival recession, but SCTG demonstrated superior results in terms of root coverage and gain in keratinized tissue width. This study underscores SCTG as the preferred technique, especially for comprehensive treatment of multiple or wide gingival defects. However, LPPG may still be a satisfactory option for isolated deep and narrow defects where patients prefer to avoid a second surgical site. The findings contribute to the evolving understanding of periodontal treatment options, highlighting the need for careful case selection to obtain optimal patient outcomes.

FAQ section (important questions/answers):

What was the purpose of the study comparing LPPG and SCTG?

The study aimed to compare the clinical outcomes of laterally positioned pedicle graft (LPPG) and subepithelial connective tissue graft (SCTG) for treating Miller's Class I and II gingival recession defects after 6 months.

What methods were used to evaluate the treatment outcomes?

Clinical parameters including recession depth, width of keratinized gingiva, percentage of root coverage, and complete root coverage were assessed at baseline and 6 months postoperatively, with statistical analysis conducted to compare intergroup and intragroup results.

How did LPPG and SCTG perform in terms of root coverage?

Both techniques achieved significant soft tissue coverage; SCTG resulted in better root coverage compared to LPPG, especially for wider and multiple defects. LPPG was more suited to isolated, deep narrow defects.

What were the results for recession depth and keratinized gingiva width?

In LPPG, recession depth decreased significantly, while width of keratinized gingiva increased. SCTG showed even greater improvements in both parameters after 6 months, indicating effective results for both techniques.

What were the conclusions drawn from the study?

Both surgical techniques improved cosmetic appearance; however, SCTG showed superior results in covering varying types of defects. LPPG is effective for specific cases where a second surgical site is not feasible.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Comparison of pedicle and connective tissue grafts for gingival recession.”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
Table refers to a structured arrangement of data in rows and columns often used in scientific literature to present research findings clearly and concisely. In the context of this study, various tables summarize key clinical results, parameters measured, and statistical comparisons between the two treatment techniques, aiding reader comprehension of complex data.

2) Study (Studying):
Study signifies a systematic investigation aimed at discovering new information, understanding phenomena, or validating existing knowledge. This specific study compared two surgical techniques for treating gingival recession, thereby contributing valuable insights into dental medicine and offering evidence-based options for patient care, enhancing treatment effectiveness.

3) Relative:
Relative typically refers to a relationship or comparison between items. In the context of this research, the term may be used when discussing the relative effectiveness of different surgical techniques or clinical outcomes. This comparison helps to identify which technique provides better results for patients undergoing gingival recession treatment.

4) Dressing:
Dressing is a protective covering applied to a wound or surgical site to promote healing and prevent infection. In this study, a periodontal dressing was utilized post-surgery to safeguard the treated area, support the healing process, and reduce discomfort for patients following gingival recession procedures performed during the trial.

5) Hygiene (Hygienic):
Hygiene refers to practices that maintain health and prevent disease, particularly through cleanliness. In dentistry, good oral hygiene is vital, especially for patients with gingival recession. The study emphasized oral hygiene instructions to ensure successful healing and optimal long-term results after surgical interventions for gum tissue recession.

6) India:
India is a country in South Asia where this clinical study was conducted, specifically at a government dental college in Ahmedabad, Gujarat. It represents the socio-cultural context and healthcare infrastructure within which the research took place, highlighting an important aspect of dental education and public health practices prevalent in the region.

7) Incision:
Incision refers to a surgical cut made in the skin or tissue to facilitate access during medical procedures. In the context of this study, incisions were critical to both surgical techniques being compared for gingival recession; they allowed for proper handling of tissue and graft placement to achieve effective results.

8) Blood:
Blood is a vital fluid that circulates in the body, delivering necessary substances like nutrients and oxygen to cells and removing waste products. In surgical procedures, maintaining an adequate blood supply is crucial for successful graft survival and wound healing, which underpins the effectiveness of the techniques evaluated in this study.

9) Measurement:
Measurement refers to the process of quantifying variables with specific instruments to gather data. In this study, key clinical parameters, such as recession depth and width of keratinized gingiva, were measured to assess the outcomes of the surgical techniques. Accurate measurements ensure sound statistical analysis and conclusions about treatment efficacy.

10) Antibiotic (Antibacterial):
Antibiotics are medications used to treat bacterial infections. In the context of this research, they were prescribed to patients post-surgery to prevent infections, a common risk during surgical interventions. Ensuring the prevention of post-operative infections is critical in enhancing the success rates and overall healing outcomes of gum surgeries.

11) Silk:
Silk, in this context, particularly refers to silk sutures used during surgical procedures for their strength and flexibility. In this study, 4-0 silk sutures were applied to secure flaps in connective tissue grafting, providing an effective means for wound approximation, ensuring stability, and promoting proper healing at the surgical site.

12) Discussion:
Discussion is a section in research papers where findings are interpreted, analyzed, and placed in the context of existing literature. In this study, the discussion evaluates the outcomes of the two surgical techniques, comparing results, addressing limitations, and identifying implications for future research and clinical practices regarding gingival recession treatment.

13) Gujarat:
Gujarat is a state in India where the study was conducted. It represents not only the geographical but also the cultural and healthcare context in which the research took place. Highlighting local practices in dentistry helps inform the applicability of results to similar populations in the region and beyond.

14) Samtana (Santana):
Santana is likely a reference to an author or researcher cited within the study, possibly related to prior research findings concerning gingival recession or surgical techniques. Citing previous studies adds credibility to current research by contextualizing findings within the broader field of periodontal research and practice.

15) Account:
Account typically refers to a narrative or description of events or outcomes. In research, it may describe the findings and methodologies used. In this study, accounts of patient experiences and outcomes provide insights into the efficacy of the surgical techniques, helping clinicians understand real-world implications of their clinical decisions.

16) Nature:
Nature refers to the inherent qualities or characteristics of something. In this research study, the nature of the gingival recession defects, including factors like depth and type, significantly influences treatment options and outcomes. Understanding these characteristics is essential for optimal management of periodontal health concerns in patients.

17) Cotton:
Cotton may refer to a material used in dental practices, often in the form of cotton pellets for cleaning or protecting sensitive areas. In this study, cotton was likely utilized as part of postoperative care to promote healing and manage hygiene around the surgical site following graft procedures.

18) Visit:
Visit refers to appointments when patients are evaluated for treatment, follow-ups, or check-ups. In this study, patient visits were critical for collecting data at multiple time points to assess the outcomes of the proposed surgical techniques for gingival recession, contributing to comprehensive results and evaluations over time.

19) Pain:
Pain is a sensory and emotional experience often associated with injury or surgery. In this study, managing post-surgical pain is crucial for patient comfort and satisfaction. Understanding the pain levels experienced by patients undergoing the different surgical techniques helps gauge the quality of care and effectiveness of the procedures.

20) Drug:
Drug refers to any substance used in the treatment, prevention, or diagnosis of disease. In this research, drugs like antibiotics and anti-inflammatory medications were used to manage post-operative care, prevent infections, and alleviate discomfort, directly contributing to the study's parameters and overall success of the surgical outcomes.

21) Life:
Life here refers to the overall quality of living and health experiences of individuals. The study aims to improve the quality of life for patients suffering from gingival recession through effective treatment strategies. Understanding the implications of surgical outcomes on patients' daily lives underscores the importance of research-driven clinical practices.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Comparison of pedicle and connective tissue grafts for gingival recession.’. Further sources in the context of Science might help you critically compare this page with similair documents:

Informed consent, Statistical analysis, Surgical Procedure, Postoperative management, Clinical outcome, Soft tissue coverage, Oral hygiene instruction, Clinical parameter, Keratinized gingiva, Root coverage, Donor Site, Periodontal dressing.

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