Patient cases:

(Maxilla)

Periodontal plastic surgery: gingival recession coverage with a xenogenic collagen matrix

Lead:

Francesco Cirillo

The American Academy of Periodontology defines the gingival recession as the displacement of marginal tissue apical to the cemento-enamel junction (CEJ). The most common factors causing gingival recession are: wrong use of the toothbrush (abrasive trauma), thin biotype, periodontitis, orthodontic factors, piercings and coronal insertion of the labial frenulum.

A 37-year-old patient, non-smoker and with absence of relevant systemic pathologies presented to the dental office with an esthetic gingival deficit and dentinal sensibility of the elements #16, #22, #24, #25 and #26 FDI. The causes of this recession are probably due to an incorrect use of the toothbrush.

The patient presented also a thin biotype and was extremely anxious, but with high esthetic and functional demands.

The objective of the treatment was to remove the dentinal sensibility and the esthetic deficit, by executing a periodontal plastic surgery. Root coverage was obtained with the use of Creos^TMmucogain, a xenogenic collagen matrix.

Evaluation & Diagnosis

Miller's class I recession on the teeth #22, #24, #25 and #26 FDI. On tooth #25 FDI. is also visible a cervical abrasion with loss of the CEJ

Miller's class I recession of the #16 FDI

Due to presence of single recessions on the #16 FDI, on the #22 FDI. and multiple recessions on the neighboring teeth #24, #25 and #26 FDI it was decided to go for three different flap designs to achieve root coverage. Moreover, due to the patient's thin gingival biotype, high anxiety status and esthetic expectations it was decided to use the xenogenic collagen matrix Creos^TMmucogain as an alternative to the Connective Tissue Graft (CTG).

Progress & Completion

Tooth #16 FDI: latero coronal flap with split thickness (Preferred flap design for non-esthetic zones)

The collagen matrix Creos mucogain is placed on the #16 FDI

The flap of the element #16 FDI is sutured (Vicryl 6.0 sutures)

Tooth #22 FDI: partial thickness trapezoidal flap

The collagen matrix Creos mucogain is applied in situ to cover the anatomical dehiscence on the 2.2

The trapeizodal flap of the element #22 FDI is sutured (Vicryl 6.0 sutures)

Paramarginal oblique incisions for the envelope flap distally of the #23 FDI till the 2.6

The collagen matrix Creos mucogain is applied on the #24 FDI and #25 FDI

The envelope flap is sutured (Vicryl 6.0 sutures)

Follow up at 8 months of the gingival recession on the #16 FDI. The total root coverage is stable

Follow up at 8 months of the single gingival recession on the #22 FDI and on the multiple recession on the #24 FDI, #25 FDI and #26 FDI. The root coverage is stable

Literature has proven the increased predictability of root coverage when using bilaminar techniques instead of the Coronally Advanced Flap (CAF) alone (Cairo e coll. 2014; Chambrone 2012; Buti e coll. 2013; Pini Prato e coll. 2014).

The use of a xenogenic collagen matrix as alternative to the CTG for root coverage of Miller's class I recessions, represents an efficient and predictable solution. Not only the post-op morbidity decreases for the patient, but also the length of the surgery and the stress on the practicioner decrease.

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Anonymous

25.10.2019 | 13:52

Hello. What the dimensions ( Mucogain Creos) are you use this case? And what the thikness? Thanks.

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Francesco Cirillo

28.10.2019 | 15:57

You can find the dimention and tickness on the Nobel biocare catalogue, creos mucogain collagen matrix .

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PRADEEP Yadalam

27.10.2019 | 11:26

CRF WITH CTG IS THE BEST

Sorry , crf with ctg is still the gold standard

Attached gingiva thickness not measured,non esthetic areas why we want recession coverage ,

Indication is wrong

We cannot prove soft tissue volume gain by this procedure

All other techniques are just comparatively ok

1 answer

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Sorry , crf with ctg is still the gold standard

Attached gingiva thickness not measured,non esthetic areas why we want recession coverage ,

Indication is wrong

We cannot prove soft tissue volume gain by this procedure

All other techniques are just comparatively ok

Francesco Cirillo

28.10.2019 | 16:00

The aim of the presentation was to prove the effectiveness of root coverage using collagen matrix. I agree with you that the use of CTG to gain soft tissue volum and tickness in still goal standard.

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Prasada Sanku

27.10.2019 | 13:47

Can you post all steps of the procedure?

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Anonymous

15.11.2019 | 10:02

Treatment procedure is good.I agree with it. Nice work.

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Anonymous

15.11.2019 | 10:05

No questions about the procedure. Totally agree with it.

Treatment procedure is good. I agree with it. Nice work.

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Treatment procedure is good. I agree with it. Nice work.

Team members

Oral surgeon

Periodontal plastic surgery: gingival recession coverage with a xenogenic collagen matrix

Evaluation & Diagnosis

Progress & Completion

Questions

Hello. What the dimensions ( Mucogain Creos) are you use this case? And what the thikness? Thanks.

CRF WITH CTG IS THE BEST

Can you post all steps of the procedure?

No questions about the procedure. Totally agree with it.

Related Publications

Team members