"Buccal fat pad graft for root coverage in severe gingival recession"

| Posted in: Science

Journal name: Journal of Indian Society of Periodontology
Original article title: Pedicled buccal fat pad graft for root coverage in severe gingival recession defect
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:

Saurav Panda, Massimo Del Fabbro, Anurag Satpathy, Abhaya Chandra Das


Journal of Indian Society of Periodontology:

(A bimonthly open-access journal)

Full text available for: Pedicled buccal fat pad graft for root coverage in severe gingival recession defect

Year: 2016 | Doi: 10.4103/0972-124X.170844

Copyright (license): CC BY-NC-SA


Summary of article contents:

Introduction

Gingival recession (GR) is a dental condition characterized by the apical displacement of marginal gingival tissue, resulting in the exposure of root surfaces. This condition can lead to various complications, including root sensitivity, pain, plaque retention, cosmetic concerns, and potential tooth loss. The severity of GR often necessitates surgical intervention, particularly in cases classified as Miller Class III and IV, which have poor prognoses with standard techniques. This case report discusses the use of pedicled buccal fat pad (PBFP) as a subepithelial graft for the effective treatment of severe GR defects, particularly in the posterior maxillary region.

Advantages of Using Pedicled Buccal Fat Pad

The pedicled buccal fat pad (PBFP) presents several advantages in managing severe GR defects. Its anatomical proximity to the recipient site allows for easy mobilization and harvesting, while the rich vascular supply ensures the viability of the graft after transplantation. The PBFP proves beneficial as it minimizes donor site morbidity and offers a reliable option for root coverage where conventional techniques may fail. In this case report, a 36-year-old male patient with Class III GR and furcation involvement underwent treatment using PBFP as a subepithelial graft. Postoperative evaluations revealed a significant attachment gain and an increase in keratinized gingiva, suggesting that PBFP could enhance the predictability and outcome of root coverage procedures in challenging cases.

Conclusion

The application of PBFP as a subepithelial graft for root coverage demonstrates promising results, especially for patients with advanced GR where other treatments may not suffice. Its favorable characteristics, such as rich vascularity, minimal complications, and straightforward harvesting, make it an attractive alternative in periodontal surgery. While further long-term studies are necessary to establish its efficacy fully, PBFP could emerge as a reliable option for effectively addressing severe maxillary posterior gingival recession, providing practitioners with a valuable tool for enhancing patient outcomes in periodontal therapy.

FAQ section (important questions/answers):

What is gingival recession and its effects on teeth?

Gingival recession (GR) is the apical displacement of gum tissue, exposing the root. It can lead to root sensitivity, pain, root caries, plaque retention, poor aesthetics, and potential tooth loss.

What are the limitations of conventional root coverage techniques?

Conventional techniques often have poor outcomes, particularly for Class III and IV GR defects. These methods typically require adequate keratinized gingiva, which is often absent in severe cases.

How is the pedicled buccal fat pad used for treatment?

The pedicled buccal fat pad (PBFP) is utilized as a graft in root coverage procedures, offering excellent blood supply and minimal donor site morbidity. It enhances healing and predictability in severe gingival recession cases.

What postoperative outcomes can be expected after PBFP treatment?

Postoperative outcomes include improved attachment levels and increased width of keratinized gingiva. In a reported case, a 6 mm attachment gain was noted within six months, indicating successful root coverage.

Are there any complications associated with using PBFP?

While PBFP is associated with minimal complications, concerns can arise regarding limited stretching of the fat pad, which might affect its vascularity. Its suitability for anterior teeth or the lower jaw is also limited.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “"Buccal fat pad graft for root coverage in severe 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) Surface:
Surface refers to the outer layer or boundary of an object. In the context of dentistry, it pertains to the exposed areas of the teeth and gums, particularly in conditions like gingival recession where root surfaces become exposed, leading to issues such as sensitivity, decay, and esthetic concerns.

2) Table:
Table generally denotes a flat, structured presentation of data or concepts. In scientific literature, tables often organize research findings for easier comprehension. Although not directly referenced, this term may metaphorically represent the organized layout of clinical results or methodologies discussed in medical reports.

3) Pur:
Poor signifies inadequate quality or condition. Within the context of oral health, it refers to subpar conditions, such as insufficient keratinized gingiva or inadequate oral hygiene. These factors exacerbate periodontal diseases and contribute to conditions like gingival recession, affecting treatment outcomes and patient satisfaction.

4) Rich (Rch):
Rich indicates abundance, particularly in terms of resources or qualities. In dental contexts, it often describes conditions like extensive blood supply that are critical for graft procedures. A rich vascular network enhances healing and tissue viability, making certain materials or approaches, like the buccal fat pad, favorable in surgeries.

5) Incision:
Incision refers to a cut or opening made during surgical procedures. In periodontal therapies, incisions are made to create flaps of tissue, allowing access to the underlying structures for treatment. Proper techniques in making incisions are crucial for minimizing complications and optimizing healing in restorative surgeries.

6) Disease:
Disease refers to a pathological condition affecting the body. In dentistry, periodontal disease encompasses conditions that involve inflammation and destruction of supportive structures of the teeth. Recognizing and treating such diseases is critical since they lead to symptoms like pain, recession, and even tooth loss if untreated.

7) Hygiene (Hygienic):
Hygiene pertains to practices that maintain health and prevent disease. In dental health, proper oral hygiene involves regular brushing, flossing, and routine professional cleanings, which help prevent gingival recession and periodontal disease. Poor oral hygiene significantly contributes to the development of dental issues which affect overall health.

8) Blood:
Blood is a vital bodily fluid that transports oxygen, nutrients, and other essential components throughout the body. In the context of periodontal procedures, blood supply is crucial for the healing of grafts and tissues. Adequate blood flow ensures that surgical sites recover properly and reduces the risk of complications.

9) Pain:
Pain is an unpleasant sensory experience often associated with injury or illness. In dental contexts, pain can arise from conditions such as gingival recession or periodontal disease, affecting patient quality of life. Understanding pain management is integral to dental practice, influencing treatment approaches and patient satisfaction.

10) Male:
Male refers to the gender classification of individuals. In dental research, it has been shown that certain oral health problems, like gingival recession, may present more frequently in males due to behavioral and anatomical differences. Studies may factor in gender as a variable influencing periodontal health outcomes.

11) Surrounding:
Surrounding pertains to areas adjacent or nearby a specific site. In dental procedures, the surrounding tissue can affect the healing process and the success of interventions like grafting. Understanding the condition of surrounding tissues is essential for planning and executing effective periodontal treatments.

12) Discussion:
Discussion refers to a comprehensive analysis or dialogue regarding findings or implications of research. In scientific articles, this section synthesizes results, provides interpretations, and suggests clinical applications. A robust discussion can enhance understanding of treatment efficacy and guide future research initiatives in periodontal therapies.

13) Harvesting (Harvest):
Harvesting involves obtaining a specific tissue or material necessary for medical procedures. In periodontal surgery, harvesting buccal fat pads exemplifies this process. It requires precision to ensure sufficient quantities are secured while maintaining donor site integrity to promote successful grafting and healing in the recipient areas.

14) Antibiotic (Antibacterial):
Antibiotic signifies a type of medication that fights bacterial infections. In periodontal treatments, antibiotics may be prescribed to manage or prevent infections post-surgery. Their usage is critical in enhancing treatment success rates, especially in patients with compromised healing due to underlying conditions.

15) Science (Scientific):
Science refers to a systematic enterprise that builds and organizes knowledge in the form of testable explanations. In dentistry, scientific principles guide the diagnosis, treatment, and preventive measures for oral health issues. Advancements in dental science continuously evolve, enhancing patient care and treatment modalities.

16) Silk:
Silk in a medical context usually refers to materials used in surgical sutures. Silk sutures are known for their strength and ease of handling. In periodontal surgery, using silk can ensure the stability and protection of grafts while promoting seamless healing at surgical sites.

17) Diet:
Diet indicates the kinds of food a person consumes. In dental health, diet plays a significant role in oral hygiene and overall health. A balanced diet contributes to healthier gums and reduced risk of decay, while poor dietary choices can exacerbate periodontal issues. Proper dietary advice is critical post-surgery.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘"Buccal fat pad graft for root coverage in severe gingival recession"’. Further sources in the context of Science might help you critically compare this page with similair documents:

Informed consent, Clinical effectiveness, Periodontal disease, Surgical Procedure, Gingival Recession, Vascular Supply, Oral hygiene instruction, Stem cell, Pedicled buccal fat pad, Keratinized gingiva, Buccal fat pad, Attachment loss, Long-term clinical trials, Root coverage procedure.

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