Management of Class-I and -II Miller Recession Using Modified Technique: A Case Report
Abstract
Background: Gingival recession is characterized by the gingival margin move apically to the mucogingival junction and cause root surface exposure. It causes a high incidence of caries, hypersensitivity and interferes with the appearance of the patient. A variety of materials and periodontal plastic surgery procedures are available to correct mucogingival problems and cover the root surface. Some treatment modifications have been developed to obtain optimal root coverage and better esthetics so that the selection of suitable treatments can affect the treatment results.
Objective: To describe the treatment result of gingival recession using several modifications of gingival recession treatment.
Case Report: A 42-year-old woman presented to the Dental and Oral Hospital of Hasanuddin University with a chief complaint of sensitive teeth when eating sweets or rinsing. Intraoral examination revealed the malposition of teeth 43 and 33, causing traumatic occlusion. Moreover, there were gingival recessions in the maxilla and mandibular regions. Recession in the maxillary right (12, 13, 14, 15, 16) was treated with tunneling technique combined with platelet-rich fibrin (PRF); recession in the maxillary left (22, 24, 26) was treated with coronally advanced flap (CAF) technique combined with PRF; and recession on mandibular (33, 43) was treated with CAF technique combined with subepithelial connective tissue graft (SCTG).
Conclusion: All combination treatments gave satisfactory results for patients but different times of healing.
Keywords: coronally advanced flap, gingival recession, platelet-rich fibrin, subepithelial connective tissue graft, tunnel technique
References
[1] Dewi AR, Susanto A, Rusyanti Y. The treatment of gingival recession with coronally advanced flap with platelet-rich fibrin. Dental Journal (Majalah Kedokteran Gigi). 2019;52(1):8-12.
[2] Kavitha J, Navarasu M, & Srikanth V. Treatment of gingival recession using coronally advanced flap-case report. International Journal of Dental Science and Research. 2014;2(1):1-4. https://doi.org/10.12691/ijdsr-2-1-1
[3] Ravipudi S, Appukuttan D, Prakash PSG, Victor DJ. Gingival recession: Short literature review on etiology, classifications and various treatment options. Journal of Pharmaceutical Science and Research. 2017;99(2): 215-20
[4] Pradeep K, Rajababu P, Satyanarayana D, Sagar V. Gingival recession: Review and strategies in treatment of recession. Hindawi. Case Reports in Dentistry. 2012; 2012: 1-6. https://doi.org/10.1155/2012/563421
[5] Krismariono A. Less invasive vestibule access tunneling with platelet-rich fibrin membrane for the treatment of gingival recession. The Journal of Contemporary Dental Practice. 2019;20(9):1024-28
[6] Parikh H, Patira S, Agrawal C, Duseja S, Shah M, Trivedi F. Clinical evaluation of autologous platelet-rich fibrin in combination with pouch and tunnel technique for the treatment of multiple adjacent gingival recession defects - A case report. World Journal of Advance Scientific Research. 2019;2(1):81-91
[7] Tengkawan M, Oktawati S, Djais AI, Burhanuddin DP. Treating gingiva recession Miller’s class I-II using platelet rich fibrin and subepithelial connective tissue graft. Dentofacial. 2013;12(3):169-74.
[8] Cohen ES. Atlas of cosmetic and reconstructive periodontal surgery. 3rd ed. Hamilton: BC Decker; 2007.
[9] Pazmino VFC, Rodas MAR, Caseres CDB, Duarte GGR, Azuaga MVC, Paula BL, et al. Clinical comparison of the subepithelial connective tissue versus plateletrich fibrin for the multiple gingival recession coverage on anterior teeth using the tunneling technique. Hindawi. Case Reports in Dentistry. 2017; 2017:1-6 https://doi.org/10.1155/2017/4949710
[10] Mazzocco F, Comuzzi L, Stefani R, Milan Y, Favero G, Stellini E. Coronally advanced flap combined with a subepithelial connective tissue graft using fullor partial thickness flap reflection. Journal of Periodontology. 2011;82(11):1524-9 https://doi.org/I10.1902/jop.2011.100586
[11] Gurlek O, Gumus P, Nizam N, Buduneli N. Coronally advanced flap with connective tissue graft or xenogenic acellular dermal matrix in the treatment of multiple gingival recession: a split-mouth randomize clinical trial. Journal of Esthetic and Restorative Dentistry. 2019;32(4): 380-88. https://doi.org/10.1111/jerd.12547
[12] Djais AI, Akbar FH, Adam M, et.al. Application of platelet rich fibrin (PRF) on endodontic-periodontic lesion in periodontal tissue regeneration: Case report. Journal of International Dental and Medical Research. 2019;12(3):1189-95.
[13] Miron RJ, Choukroun J. Platelet rich fibrin in regenerative dentistry. Oxford: Wiley Blackwell; 2017.
[14] Saraiva JA, Campos EA, Cavassim R, et al. Subepithelial connective tissue graft: A case report. The South Brazilian Dentistry Journal. 2011;8(3):357-62
[15] Alghamdi H, Babay N, Sukumaran A. Surgical management of gingival recession: A clinical update. The Saudi Dental Journal. 2009;21(2):83-94 https://doi.org/10.1016/j.sdentj.2009.07.006