Patient-centered analysis of PRF-enhanced vs. Zucchelli's technique
Journal name: Journal of Indian Society of Periodontology
Original article title: Patient-centered comparative outcome analysis of platelet-rich fibrin-reinforced vestibular incision subperiosteal tunnel access technique and Zucchelli's technique
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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S. Raja Rajeswari, M.G Triveni, A.B. Tarun Kumar, P. L. Ravishankar, M. Prem Blaisie Rajula, Lydia Almeida
Journal of Indian Society of Periodontology:
(A bimonthly open-access journal)
Full text available for: Patient-centered comparative outcome analysis of platelet-rich fibrin-reinforced vestibular incision subperiosteal tunnel access technique and Zucchelli's technique
Year: 2021 | Doi: 10.4103/jisp.jisp_187
Copyright (license): CC BY-NC-SA
Summary of article contents:
Introduction
Gingival recession is a prevalent issue that affects many patients, particularly in esthetically sensitive areas. Multiple gingival recession (MGR) requires effective treatment strategies to enhance patient satisfaction while ensuring optimal clinical outcomes. Among various surgical techniques, the Coronally Advanced Flap (CAF) methods, particularly Zucchelli's Technique (ZT) and Vestibular Incision Subperiosteal Tunnel Access (VISTA), have garnered attention for their results in MGR management, especially when enhanced with biological agents like platelet-rich fibrin (PRF). This study aimed to compare the effectiveness of these two techniques, assessing their impact on root coverage, patient comfort, and overall esthetics.
The Importance of Patient-Centered Outcomes
The study highlighted the significance of patient-centered outcomes (PCO) in evaluating the success of periodontal treatments. While both ZT and VISTA techniques demonstrated similar efficacy in achieving high root coverage percentages—96.84% and 93.95% respectively—the subjective evaluation revealed a preference for the VISTA technique among patients. Patients reported less postoperative discomfort and superior aesthetic outcomes with VISTA due to its minimally invasive design, which involves a single vertical incision, reducing trauma to the surrounding tissues. The improved healing associated with the PRF addition further reinforced the benefits of VISTA, making it a preferable choice for managing MGR in patients who prioritize comfort and esthetics.
Conclusion
In conclusion, both ZT and VISTA techniques are effective in managing MGR, offering satisfactory clinical results. However, from a patient-centered perspective, the VISTA technique emerged as the superior option due to its minimal postoperative morbidity and enhanced aesthetic outcomes, aligning with patients' preferences. This study underscores not only the clinical effectiveness of surgical techniques but also the need to consider patient comfort and satisfaction as critical components of successful periodontal management. The findings advocate for the integration of PCO measures in clinical practices to ensure holistic care in periodontal surgery.
FAQ section (important questions/answers):
What are the benefits of using the Zucchelli's technique (ZT)?
ZT offers predictable treatment for multiple gingival recessions with good color blending and thickness. The unique split-full-split thickness elevation respects vascular specifics, allowing for improved root coverage, even in areas of reduced width of keratinized gingiva.
How does the Vestibular incision subperiosteal tunnel access (VISTA) technique compare?
VISTA allows for simultaneous management of multiple gingival recessions and features an atraumatic incision design. This facilitates easier introduction of biomaterials while reducing surgical morbidity and enhancing patient acceptance due to minimal discomfort.
What were the primary outcomes observed in this study?
The study indicated that both ZT and VISTA techniques were effective, achieving high root coverage percentages. However, patients displayed a preference for VISTA due to its less invasive nature and improved esthetic outcomes postoperatively.
What limitations were identified in the study regarding techniques used?
A key limitation was the lack of histological examination to evaluate true periodontal regeneration. Additionally, factors affecting platelet-rich fibrin quality were not taken into consideration, which could influence the outcomes.
What precautions should be considered when using these surgical techniques?
Ensure prompt collection and processing of PRF. In ZT, precise planning of incisions and blade orientation is crucial for optimal healing. For VISTA, the proper placement of the vertical incision is essential for effective flap mobilization.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Patient-centered analysis of PRF-enhanced vs. Zucchelli's technique”. 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:
In the context of scientific research, tables are structured formats for organizing and presenting data clearly and concisely. They allow researchers to compare results across different groups or conditions, making it easier to discern patterns, trends, and statistical significance of findings related to the study's objectives.
2) Incision:
An incision refers to the surgical cut made in the skin or tissue. It is crucial in dental procedures such as the ZT and VISTA techniques as it determines access to the target area, influences healing, impacts postoperative pain, and can affect overall aesthetic outcomes post-surgery.
3) Study (Studying):
The term 'study' denotes a systematic investigation aimed at discovering new information, validating existing knowledge, or evaluating treatments. In the context of this research, it involves comparing surgical techniques for managing multiple gingival recession, emphasizing methodology, outcomes, and implications for clinical practice.
4) Post:
In medical and clinical research, 'post' typically refers to the period following an intervention or treatment, such as postoperative evaluations. It is crucial for assessing the effectiveness and outcomes of procedures, including patient satisfaction and recovery metrics, which are vital for evaluating healthcare interventions.
5) Relative:
The term 'relative' is used to compare different aspects or measures within research outcomes. It denotes the importance of looking at one variable's performance compared to another, which is essential for understanding the effectiveness of one surgical method over another in this study.
6) Surface:
The term 'surface' can refer to the exposed area of anatomical structures, like tooth surfaces subjected to surgical procedures. In gingival recession treatment, understanding the characteristics of the root surface or gum tissue surface can greatly influence the outcome, healing, and aesthetic integration post-surgery.
7) Perception:
Perception in medical studies refers to patients' subjective opinions and experiences regarding their treatment, including pain management, aesthetic outcomes, and overall satisfaction. This term is particularly relevant in evaluating postoperative results where patients can express their views on treatment effectiveness and comfort.
8) Rich (Rch):
In the context of this study, 'rich' refers to the quality, abundance, or concentration of beneficial components, such as growth factors in platelet-rich fibrin (PRF). A rich PRF contains essential nutrients promoting better healing, regenerative processes, and enhancing overall postoperative outcomes in surgical interventions.
9) Hygiene (Hygienic):
Hygiene refers to practices conducive to maintaining health and preventing disease, particularly concerning oral care. For post-surgical patients, proper hygiene is paramount to ensure healing, prevent infections, and ensure long-term success of procedures like gingival recession management, making patient education critical.
10) Measurement:
Measurement denotes the process of quantifying certain parameters during research to assess outcomes and effectiveness. In this study, measurement involving parameters like recession depth, gingival thickness, and patient comfort scores are vital for objectively evaluating the success of the techniques applied.
11) Account:
In medical research, 'account' often refers to considering or acknowledging specific variables and parameters that may influence outcomes. When interpreting results, it is essential to account for factors like patient demographics, techniques used, and rehabilitation methods to achieve valid conclusions.
12) Line:
The term 'line' can refer to protocol lines in surgical techniques (e.g., incision lines), guiding the path of interventions. In research, it may also indicate a methodological or analytical approach/categorization related to treatment effectiveness, ensuring scientific rigour in obtaining results.
13) Pain:
Pain is a significant measurement in clinical studies as it directly impacts patient comfort, satisfaction, and recovery quality post-surgery. Understanding pain perception from treatments like ZT and VISTA is essential in evaluating the overall success of procedures aimed at managing gingival recession.
14) Composite:
Composite refers to materials made up of different elements. In dental surgery, composite materials may relate to restorative materials used for enhancing aesthetics after procedures. Their use ensures functional restoration, contributing positively to overall patient satisfaction after surgical interventions involving recession management.
15) Science (Scientific):
Science represents the systematic pursuit of knowledge and understanding. In this context, it relates to the evidence-based practices being assessed through clinical studies focusing on techniques to improve patient outcomes in dentistry, underscoring the importance of research in advancing medical practices.
16) Kumar:
Kumar likely refers to a researcher or author whose work contributes to the field, offering insights and studies relevant to the subject matter discussed. Citing literature from Kumar underlines the importance of previous research and scholarly contributions to ongoing investigations in this area.
17) Rules:
Rules in medical research can refer to established protocols and guidelines that dictate the proper conduct of studies. They are essential for ensuring validity, reliability, and ethical considerations in the management of clinical trials and patient safety throughout various surgical procedures.
18) Blood:
Blood is critical in surgical contexts, particularly concerning healing and recovery. Understanding blood flow and its components, like PRF, informs how regeneration occurs post-surgery. It encompasses factors like clot formation, healing dynamics, and inflammatory responses that play key roles in patient recovery.
19) Inflammation:
Inflammation is a biological response essential in the healing process post-surgery; however, excessive inflammation can impede recovery. Evaluating inflammation levels is crucial in understanding the body's response to surgical trauma and can influence the effectiveness of surgical techniques for gingival management.
20) Calculation:
Calculation refers to the process of using mathematical methods to analyze and interpret data. In research, accurate calculations ensure the results are statistically valid and provide insights into treatment effectiveness, patient satisfaction, and other key parameters essential for clinical decision-making.
21) Performance:
Performance typically reflects the effectiveness of a surgical technique in achieving desired goals, such as tissue healing or aesthetic results. Assessing the performance of ZT versus VISTA would involve looking at clinical outcomes, patient satisfaction, and the overall success rate of the methodologies employed.
22) Observation:
Observation is integral to clinical research, involving close monitoring of patients' responses to treatment over defined periods. In the context of this study, observation of healing and recovery outcomes provides essential data to assess the success of the surgical techniques being compared.
23) Discussion:
Discussion is a critical segment in research articles where results are interpreted, contextualized, and implications for practice are drawn. It reflects on findings, explores limitations, and suggests future research directions, facilitating a deeper understanding of the studied techniques' relevance in clinical dentistry.
24) Antibiotic (Antibacterial):
Antibiotic refers to medications used to combat infections, often prescribed post-surgery to prevent complications. Understanding the role of antibiotics in post-operative care is key to ensuring optimal healing and reducing the risk of infection in surgical treatments related to gingival recession management.
25) Activity:
Activity in a medical research context often refers to physiological processes or patient engagement in recovery. Monitoring activity levels, both physical and cellular (like healing processes), provides insights into the recovery trajectory and efficacy of the surgical techniques applied in the study.
26) Bleeding:
Bleeding is a common concern in surgical procedures, indicating the need for effective hemostasis methods during operations. Monitoring post-operative bleeding is crucial as it affects recovery outcomes and can impact patient comfort, necessitating careful management during gingival recession interventions.
27) Pregnant:
Pregnant patients present unique challenges in surgical procedures due to altered physiological states. Excluding pregnant patients from studies ensures safety and ethical considerations in research design, as procedures can potentially impact maternal and fetal health, which must always be meticulously weighed.
28) Raising:
Raising directly relates to surgical practices, particularly in the context of flap procedures in gingival recession management. Flap raising techniques dictate how tissue is manipulated, which directly influences healing and aesthetic outcomes post-surgery, illustrating its importance in surgical methodology.
29) Tearing:
Tearing in dental surgery context refers to the unintentional damage to soft tissue that can occur during incision planning or flap manipulation. Understanding tearing risk is essential for maintaining surgical integrity and minimizing complications, ensuring optimal recovery pathways for patients post-surgery.
30) Edema (Oedema):
Edema refers to fluid accumulation and swelling post-surgery, which serves as an indicator of inflammatory responses in healing tissues. Monitoring edema is crucial for assessing recovery, guiding further intervention if needed, and ensuring the comfort and satisfaction of patients undergoing surgical procedures.
31) Visit:
Visit refers to follow-up appointments where patient recovery is assessed, postoperative results evaluated, and necessary modifications to care are discussed. Regular visits are essential to ensure proper healing, timely interventions in case of complications, and reinforcement of oral hygiene practices post-surgery.
32) Tear:
Tear can refer to damage sustained by tissues during surgical procedures. Proper technique and careful management are essential to prevent tears, which can negatively impact healing outcomes and may require additional intervention or correction, highlighting the importance of procedural precision.
33) Gold (Golden):
Gold represents the conventional standard of treatment against which newer methods are compared. In this context, it signifies the traditional techniques that yield successful outcomes, serving as benchmarks to evaluate the efficacy and advancements of innovative surgical methods like ZT and VISTA.
34) Drug:
Drug typically refers to therapeutic agents used to treat or prevent disease, including antibiotics that may be prescribed postoperatively. Understanding how drugs interact with surgical outcomes and patient recoveries is vital for optimizing treatment protocols and ensuring effective management of patient health.
35) Male:
Male refers to the gender demographic that may participate in the study, which is significant in understanding how responses to treatment may vary based on gender. Recognizing gender differences in healing and recovery can aid in tailoring more effective surgical approaches for patients.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Patient-centered analysis of PRF-enhanced vs. Zucchelli's technique’. Further sources in the context of Science might help you critically compare this page with similair documents:
Visual analog scale, Postoperative care, Clinical attachment level, Oral hygiene instruction, Clinical parameter.