Free Gingival Graft as a Single Step Procedure for Treatment of Mandibular Miller Class I and II Recession Defects

Lata Goyal, Narender Dev Gupta, Namita Gupta, Kirti Chawla, Lata Goyal, Narender Dev Gupta, Namita Gupta, Kirti Chawla

Abstract

Background: Gingival recession is a frequent issue encountered by both the clinician and the patient. This study was aimed to assess the predictability of the free gingival graft as a single step procedure in terms of root coverage and aesthetics in Miller Class I and II mandibular gingival recession.

Methods: Ten patients (4 males, 6 females) aged 25-30 years with a total of 12 mandibular sites having Miller class I and II recession were selected. All recession sites were treated with single step free gingival graft procedure. Clinical parameters like recession depth, recession width, width of attached gingiva, probing depth and clinical attachment level were recorded at baseline, 6 and 9 months. Visual analog score at 1, 6 and 9 months postoperatively was provided.

Results: There was a reduction in mean recession depth from 3.66±1.20 to 0.91±0.99 mm suggesting coverage of 82% over a period of 9 months. There was statistically significant gain in clinical attachment level and width of attached gingiva. Aesthetically, it was acceptable by patients as measured by visual analog scores.

Conclusion: Free gingival graft as a single step procedure is acceptable in terms of root coverage and aesthetics.

Keywords: Aethetics; Gingival recession; Perioplastic surgery.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Preoperative view showing Miller Class II recession associated with tooth 41
Fig. 2
Fig. 2
Free gingival graft
Fig. 3
Fig. 3
Graft is placed to prepared mucoperiosteal bed and sutured by interdental, horizontal and circumferential suture
Fig. 4
Fig. 4
Surgical site after removal of sutures
Fig. 5
Fig. 5
9 month postoperative view

References

    1. Glossary of Periodontal terms. 4th ed. Vol 44. Chicago: The American Academy of Periodontology ; 2001. p. 32.
    1. Wennström J. Mucogingival therapy. Ann Periodontol. 1996;1:671.
    1. Dorfman HS, Kennedy JE, Bird WC. Longitudinal evaluation of free autogenous gingival grafts. J Clin Periodontol. 1980;7:316–24.
    1. Miller PD Jr. Root coverage using the free soft tissue autograft following citric acid application III A successful and predictable procedure in areas of deep-wide recession. Int J Periodontics Restorative Dent. 1985;5:14–37.
    1. Bouchard P, Malet J, Borghetti A. Decision-making in aesthetics: root coverage revisited. Periodontol. 2001;27:97–120.
    1. Gray JL. Commentary –when not to perform root coverage procedures. J Periodontol. 2000;71:1048–50.
    1. Grupe J, Warren R. Repair of a gingival defect by a sliding flap operation. J Periodontol. 1956;27:290–95.
    1. Bernimoulin JP, Luscher B, Muhlemann HR. Coronally repositioned periodontal flap Clinical evaluation after one year. J Clin Periodontol. 1975;2:1–13.
    1. Pini Prato G, Tinti C, Vincenzi G, Magnani C, Cortellini P, Clauser C. Guided tissue regeneration versus mucogingival surgery in the treatment of human buccal gingival recession. J Periodontol. 1992;63:919–28.
    1. Langer B, Langer L. Subepithelial connective tissue graft technique for root coverage. J Periodontol. 1985;56:715–20.
    1. Hangorsky U, Bissada NF. Clinical assessment of free gingival graft effectiveness on the maintenance of periodontal health. J Periodontol. 1980;51:274–8.
    1. Camargo PM, Melnick PR, Kenney EB. The use of free gingival graft for aesthetic purposes. J Periodontol . 2001;27:72–96.
    1. Berlucchi I, Francetti L, Del Fabbro M, Basso M, Weinstein RL. The influence of anatomical features on the outcome of gingival recessions treated with coronally advanced flap and enamel matrix derivative: a 1-year prospective study. J Periodontol. 2005;76:899–907.
    1. Remya V, Kishore Kumar K, Sudharsan S, Arun KV. Free gingival graft in the treatment of class III gingival recession. Indian J Dent Res. 2008;19:247–52.
    1. Holbrook T, Ochsenbein C. Complete coverage of the denuded root surface with a one-stage gingival graft. Int J Periodontics Restorative Dent. 1983;3:8–27.
    1. Lang NP, Loe H. The relationship between the width of keratinized gingiva and gingival health. J Periodontol. 1972;43:623–7.
    1. Bernimoulin JP, Luscher B, Muhlemann HR. Coronally repositioned periodontal flap Clinical evaluation after one year. J Clin Periodontol. 1975;2:1–13.
    1. Wennström JL, Pini Prato GP. Mucogingival therapy. In: Lindhe J, Karring T, Lang NP, editors. Clinical periodontology and implant dentistry. 3rd ed. Copenhagen: Munksgaard; 1997. pp. 550–96.
    1. Roccuzzo M, Bunino M, Needleman I, Sanz M. Periodontal plastic surgery for treatment of localized gingival recessions: a systematic review. J Clin Periodontol. 2002;29:178–94; discussion 95-6.
    1. Miller Jr P. Root Coverage with Free Gingival graft Factor associated with incomplete root coverage. J Periodontal. 1987;58:674–81.
    1. Borghetti A, Gardella JP. Thick gingival autograft for the coverage of gingival recession: a clinical evaluation. Int J Periodontics Restorative Dent. 1990;10:216–29.
    1. Oates TW, Robinson M, Gunsolley JC. Surgical therapies for the treatment of gingival recession A systematic review. Ann Periodontol. 2003;8:303–20.

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