RESUMEN
The use of guided tissue regeneration (GTR) procedures in the treatment of gingival recession has shown promising results and is gaining clinical acceptance. The purpose of this study was to assess the use of a bioabsorbable collagen membrane as a barrier device in root coverage treatment of gingival recession defects. The study consisted of 10 patients with 10 defects of either Miller Class I or II description and gingival recession > or =2.5 mm. Clinical measurements taken at baseline included plaque index (PI) and gingival index (GI), clinical attachment level (CAL) measured with an automated probe and reference stent, recession depth (RD; mean = 3.19 +/- 0.26 mm), recession width (RW; 3.95 +/- 0.41 mm), probing depth (PD; 2.3 +/- 0.2 mm), and width of keratinized tissue (KT; 2.4 +/- 0.3 mm); measurements were repeated at 1, 2, and 4 weeks and 3 and 6 months post-treatment. During the surgical procedure, a mucoperiosteal flap was elevated and the respective root thoroughly planed. The collagen membrane was cut to cover the defect and surrounding bone, positioned over the root, and secured with 5-0 gut interdental sutures. The flap was coronally positioned to cover the membrane and sutured with 5-0 silk. Data were analyzed using the Student paired t-test to compare pre- and postsurgery measurements. The nonparametric Wilcoxon matched pairs test was used to analyze the significance of PI and GI at different time intervals. A statistically significant (P < 0.01) reduction in RD (-1.66 +/- 0.25 mm) was observed at 6 months, representing 51.6% total attainable root coverage. Clinically, a statistically significant mean gain of 1.34 +/- 0.47 mm CAL and 0.90 +/- 0.32 mm KT was observed at 6 months. No statistical differences were found in PD and RW between baseline and 6 months postoperatively. PI and GI remained low and showed no statistically significant change (P < 0.05) throughout the study period. Results from this study suggest that a collagen membrane can be used successfully as a barrier device in GTR-based root coverage procedures.
Asunto(s)
Colágeno , Recesión Gingival/cirugía , Regeneración Tisular Guiada Periodontal , Membranas Artificiales , Raíz del Diente/patología , Absorción , Adulto , Anciano , Índice de Placa Dental , Epitelio/cirugía , Estudios de Evaluación como Asunto , Femenino , Estudios de Seguimiento , Recesión Gingival/patología , Gingivoplastia , Humanos , Masculino , Análisis por Apareamiento , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/patología , Pérdida de la Inserción Periodontal/cirugía , Índice Periodontal , Bolsa Periodontal/patología , Bolsa Periodontal/cirugía , Aplanamiento de la Raíz , Colgajos QuirúrgicosRESUMEN
Predictable coverage of exposed root surfaces and the corresponding treatment of gingival recession defects remain important objectives of periodontal therapy. A variety of techniques have been developed during the past several decades to address this common clinical challenge. Traditional surgical approaches have been relatively successful in achieving root coverage. Attempts have been made recently to achieve root coverage with surgical techniques based on the principles of guided tissue regeneration, using resorbable and nonresorbable materials. The learning objective of this article is to present case documentations of root coverage, using a resorbable collagen barrier. The results achieved illustrate the potential of this material in the treatment of gingival recession. The biologic properties of collagen as a barrier material, the surgical approach, and the principles of case selection are reviewed.