Allison, N Rascon
Talin Mirzoyan
Edgar El Chaar
| Allison, N Rascon | Talin Mirzoyan | Edgar El Chaar |
Allison, N Rascon, Talin Mirzoyan, Edgar El Chaar
Periodontics, University of Pennsylvania School of Dental Medicine
Introduction
Gingival recession is the apical migration of gingival margin to the cementoenamel junction (CEJ). The presence of recession is not only aesthetically unacceptable for many patients but can also be associated with hypersensitivity and potential the risk for further periodontal attachment loss. Gingival recession can be caused by various etiologies, and similarly can be treated by a variety of surgical approaches. Root coverage with acellular dermal matrix using the tunneling technique can be a useful alternative to traditional techniques, especially for multiple recession defects in maxillary premolar and anterior teeth.
Methods
Two patients presented to the Department of Periodontics with complaints of sensitivity due to recession. Root coverage procedures were carried out using the tunneling technique in one case, and the tacking technique in the other, along with placement of an allograft tissue matrix and coronal advancement of the flap. The tunneling technique as described by Pat Allen et al. was implemented, and the tacking technique was employed via stabilization of ADM by placement of titanium tacks.
Results
Both cases present with several months follow up, clinically portraying sound, stable levels of the gingival margin. Patient-centered outcomes were assessed as well, such as esthetics, complications, and patient perceptions.
Conclusion
This case series is to demonstrate a modified technique using acellular dermal matrix (ADM) to augment the soft tissue and eradicate gingival recession. These methods achieve faster healing with less postoperative morbidity. Both root coverage procedures provided significant reduction in recession depth and CAL gain for Miller and/or Cairo recession- type defects, along with improvement in patient reported satisfaction. However, future studies that include larger sample sizes, longer follow-up periods, and a randomized controlled design are needed to truly examine the effect of these treatment modalities.