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Predictability of Maximum Root Coverage in Muco-Plastic Surgery of Localized Gingival Recession

Publié
Serveur de preprints
Preprints.org
DOI
10.20944/preprints202411.1434.v1

Background : Gingival recession poses significant challenges in dental clinics and impacts almost half of the global population, predominantly affecting older adults. It occurs more frequently in the lower teeth than the upper teeth, which have thicker and more robust keratinized tissues. A range of surgical procedures, referred to as mucogingival surgeries, are employed to tackle this condition. These techniques, categorized under plastic surgery, strive to cover the exposed tooth roots, thereby diminishing sensitivity, facilitating hygiene maintenance, and enhancing aesthetics affected by gingival recession. Aim of study: to underscore the efficacy of predicting maximum root coverage in treating gingival recession with coronal advancement flap (CAF) and autogenous subepithelial connective tissue grafts (CTG). This is achieved by comparing the predetermined maximum root coverage (MRC) with the actual outcomes of root coverage surgical procedures. Methods: Patients with Gingival Recessions Type (RT)1 and RT2 were treated with Coronal advancement flap with a connective tissue graft (CTG). The treatment protocol comprised scaling and root planing, along with root surface conditioning. Subsequently, a surgical phase was conducted, involving a sub-epithelium connective tissue graft placed . This included the harvest of the graft from the palatal mucosa and its placement at the recipient site. Post-operative care instructions were provided, accompanied by a comprehensive follow-up schedule for one month. Results: there is no significant difference between the predetermine level of root coverage and the actual outcome postoperatively. In the case 1, full root coverage was attained, demonstrating both long-term stability and aesthetic achievement. Conversely, in the second case, root coverage reached 80% with attachment level gain and a gingival margin that was harmonious with adjacent teeth. It is deemed a successful clinical result. Conclusion: The successful outcomes of combining Coronally Advanced Flap (CAF) with Connective Tissue Graft (CTG) in treating gingival recession of Miller class II and III cases have underscored the efficacy of predetermined assessments. These assessments enhance the clinician's ability to accurately predict the maximum root coverage achievable before surgery, which is vital for the success of regenerative treatments. Further randomized clinical trials with extended follow-ups are required.

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