Management of gingival recession with unit grafts post attachment loss
Journal name: Journal of Indian Society of Periodontology
Original article title: Successful management of gingival recession with interdental attachment loss using gingival unit grafts
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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Neelima Katti, Devapratim Mohanty, Poonam Agrawal, Subash Chandra Raj, Shib Shankar Pradhan, Debjani Baral
Journal of Indian Society of Periodontology:
(A bimonthly open-access journal)
Full text available for: Successful management of gingival recession with interdental attachment loss using gingival unit grafts
Year: 2022 | Doi: 10.4103/jisp.jisp_539
Copyright (license): CC BY-NC-SA
Summary of article contents:
Introduction
Gingival recession, characterized by the apical shift of marginal gingiva, results in the exposure of tooth surfaces and can lead to root surface denudation devoid of periodontal attachment. Among the various treatment modalities, the gingival unit graft (GUG) has emerged as a promising alternative to free gingival grafts (FGGs) in achieving root coverage, especially in recession defects classified as RT2 and RT3, which are associated with interdental attachment loss. This study aimed to evaluate the efficacy of GUG in treating RT2 recession defects over a six-month period and to explore the relationship between baseline clinical parameters—such as recession depth (RD), recession width (RW), and interdental clinical attachment levels (iCAL)—and the percentage of mean root coverage (MRC) achieved.
Importance of Recession Width in Root Coverage
An important finding of the study was the significant relationship between recession width and the amount of root coverage achieved. The results demonstrated that a 1 mm decrease in recession width corresponded with a notable 5.25% increase in MRC at the six-month mark (P = 0.04). At the conclusion of the study, the mean MRC was reported at 81.79% ± 6.16%, indicating substantial coverage of exposed root surfaces. This correlation underscores the role of preoperative recession width as a critical predictive factor for the success of gingival grafting procedures. Despite none of the sites achieving complete root coverage, a reduction in recession width substantially influenced graft performance, highlighting the importance of accurate assessment before surgical interventions.
Conclusion
The findings suggest that gingival unit grafts can be effectively utilized to enhance root coverage in cases of RT2 recession defects, successfully increasing keratinized tissue width in the process. The study establishes that recession width is the most significant predictor of the outcome in this context, which can guide clinicians when planning surgical treatments for gingival recession. Further research, including controlled studies with longer follow-up periods, is encouraged to optimize the use of GUG techniques and to provide additional insights into their long-term efficacy in periodontal management.
FAQ section (important questions/answers):
What is the purpose of the gingival unit graft?
The gingival unit graft (GUG) aims to cover denuded root surfaces, improve keratinized tissue width, and enhance aesthetic outcomes in patients with RT2 recession defects, particularly in areas with the loss of interdental attachment.
How was the clinical efficacy of GUG measured?
The study measured clinical parameters like recession depth, width, and interdental clinical attachment levels before and after treatment. The percentage of mean root coverage was calculated at three and six months post-surgery.
What results were achieved with GUG after six months?
After six months, the study reported an impressive mean root coverage of 81.79%. This indicates that GUG is effective in achieving significant root coverage in patients with RT2 recession defects.
What factors influence the success of root coverage procedures?
Factors affecting the success include recession width, recession depth, and interdental clinical attachment levels. The study noted that a decrease in recession width significantly increased root coverage percentages.
What were the main conclusions drawn from the study?
The study concluded that GUG is effective for root coverage in RT2 recession defects. Additionally, recession width is a significant predictor of root coverage success, highlighting the importance of thorough clinical assessment.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Management of gingival recession with unit grafts post attachment loss”. 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:
A table organizes data for quick reference and analysis. It visually presents statistical results, allowing readers to easily compare clinical parameters, such as recession depth and width, across time intervals. In research studies, tables summarize findings, fostering a clear understanding of complex information and supporting conclusions about treatment efficacy.
2) Study (Studying):
A study systematically investigates a specific hypothesis or research question, employing methods to collect and analyze data. In this context, the study evaluates the effectiveness of gingival unit grafts for treating root recession defects. It provides a controlled environment for assessing treatment outcomes and understanding clinical parameters related to patient health.
3) Surface:
Surface refers to the outer layer exposed to the environment, in dentistry often concerning tooth surfaces that might become denuded due to gingival recession. Understanding the root surface is critical in procedures like grafting as the survival rate of grafts largely depends on the condition and treatment of these exposed surfaces.
4) Hygiene (Hygienic):
Hygiene is the practice of maintaining health through cleanliness, essential in dental procedures. Effective oral hygiene minimizes plaque and bleeding, ensuring a favorable environment for healing post-surgery. In this study, participants' oral hygiene was monitored to determine its impact on the success rate of graft treatment methods employed.
5) Relative:
Relative involves comparing or relating one parameter to another, providing context for understanding research findings. In this study, the relative clinical attachment level (rCAL) assesses periodontal health. By evaluating this measurement against other factors like recession depth, clinicians can gauge treatment outcomes and the viability of specific surgical approaches.
6) Incision:
An incision is a surgical cut made to facilitate medical procedures or aesthetic interventions. Proper incisions in periodontal surgery, such as those for gingival grafts, are crucial as they determine the graft’s success and subsequent integration with the surrounding tissues, affecting clinical outcomes and patient recovery.
7) Rules:
Rules in research refer to established guidelines or protocols that ensure consistency and validity. These rules govern the methodology used in studies, from patient selection to measurement parameters, ensuring that findings are credible and reproducible and that ethical standards are met in the research process.
8) Blood:
Blood is essential for healing tissues and graft integration, supplying oxygen and nutrients to surgical areas. In gingival unit grafts, adequate blood supply is crucial for graft viability. The study emphasizes the role of blood circulation from recipient sites in achieving successful outcomes in root coverage procedures.
9) Post:
Post refers to the period after a surgical procedure, during which healing and recovery take place. In the context of this study, postoperative evaluations assess the outcomes and complications of graft placements, helping to understand the long-term effectiveness of the surgical techniques applied in treating periodontal defects.
10) Measurement:
Measurement involves quantifying clinical parameters, crucial in evaluating treatment effectiveness. Accurate measurements of recession depth, width, and clinical attachment levels inform clinicians about patient progress. In this study, measurement techniques provided critical data for statistical analyses and assessment of the efficacy of gingival unit graft treatments over time.
11) Harvesting (Harvest):
Harvesting refers to the process of obtaining tissue, such as donor grafts from the palate in periodontal surgery. Proper harvesting techniques ensure the graft's viability and integration potential, directly impacting the treatment's success rate. This study examines harvesting methods for gingival unit grafts, underscoring their importance in surgical outcomes.
12) Bleeding:
Bleeding is a significant consideration in surgical procedures, as excessive blood loss can complicate recovery and affect surgical outcomes. In this study, managing bleeding during gingival graft procedures is essential. Monitoring bleeding levels post-surgery helps assess the healing process and the graft's integration into surrounding tissues.
13) Disease:
Disease refers to pathological conditions affecting health, such as periodontal disease, which contributes to gingival recession. Understanding disease impacts is crucial in clinical studies assessing treatment efficacy, as the presence of disease complicates the surgical intervention's success. This study's focus on healthy subjects helps isolate treatment effects.
14) Calculation:
Calculation involves determining numerical values from data collected during research. In this context, it pertains to analyzing clinical parameters to determine mean root coverage percentages and other outcomes. Accurate calculations are vital for understanding treatment effects and informing future clinical practices based on empirical evidence collected.
15) Discussion:
Discussion involves interpreting research findings in the context of existing literature, addressing implications, and proposing further directions for study. In this research, the discussion section evaluates the results of gingival unit grafts, compares them with prior knowledge, and elucidates their significance in improving periodontal treatment practices and patient outcomes.
16) Antibiotic (Antibacterial):
Antibiotics are medications used to treat infections by inhibiting bacterial growth. In dental surgery, prophylactic antibiotics may be prescribed to prevent infections following procedures like gingival grafting, emphasizing their role in enhancing healing and minimizing complications. This study considers the use of antibiotics for patient safety and recovery.
17) Attending:
Attending refers to the act of being present at a location or event, in this case, it refers to patients attending dental clinics for treatment. The study involves patients actively seeking care for gingival recessions, highlighting the importance of access to dental services and their implications for health and treatment outcomes.
18) Pregnant:
Pregnant refers to the condition of carrying a developing embryo or fetus. In medical studies, pregnant patients are often excluded from clinical trials due to potential risks associated with treatments. This study specifies exclusion criteria regarding pregnancy to ensure the safety and health of both the mother and the fetus during surgical procedures.
19) Science (Scientific):
Science is the systematic study of the structure and behavior of the physical and natural world through observation and experimentation. In the context of this study, scientific methods underpin the research on periodontal treatments, employing evidence-based approaches to assess the clinical effectiveness of gingival unit grafts in restoring dental health.
20) Beta:
Beta often denotes a statistical measure or coefficient indicating the relationship between variables in regression analysis. In this study, beta coefficients help interpret the influence of recession width on mean root coverage outcomes, providing insights into predictors of surgical success and informing clinical decision-making processes based on statistical evidence.
21) Silk:
Silk refers to a type of material, often used for sutures in surgical procedures due to its strength and biocompatibility. In dental surgery, silk sutures secure grafts in place during healing. The study mentions silk sutures as part of the surgical protocol, highlighting their importance for patient recovery and graft stability.
22) Sign:
Sign refers to any indicator or condition observable during a medical examination, contributing to the diagnosis or assessment of health status. In research, significance can indicate the statistical relevance of findings, helping to interpret the efficacy of treatments and guiding clinical decisions based on their importance in improving patient health.
23) Drug:
Drug refers to any substance that causes a change in physiological state, including medications that can influence healing or pain management. In this study, references to drugs can relate to those prescribed for managing discomfort or preventing infection post-surgery, highlighting the role of pharmacological intervention in achieving successful treatment outcomes.
24) Male:
Male is a biological classification referring to one of the two primary sexes in many species, including humans. In this study, demographic parameters such as gender (male or female) may be analyzed for their influence on clinical outcomes, acknowledging that gender differences can play a role in health conditions, treatment responses, and recovery.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Management of gingival recession with unit grafts post attachment loss’. Further sources in the context of Science might help you critically compare this page with similair documents:
Statistical analysis, Surgical Procedure, Oral hygiene maintenance, Gingival Recession, Clinical outcome, Clinical parameter, Free gingival graft, Mean age of participants.