Root Coverage Associated with Acellular Dermal Matrix and L-Prf in Bilateral Unitary Gingival Recessions – Case Report

Authors

  • Anne Carolinne Neves Damião Department of periodontology, School of Dentistry, University Center of State of Pará, Belém, Pará, Brazil
  • Geovana Feitosa dos Santos Department of periodontology, School of Dentistry, University Center of State of Pará, Belém, Pará, Brazil
  • Ricardo Roberto de Souza Fonseca Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil
  • Luiz Fernando de Almeida Machado Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém, Pará, Brazil
  • Silvio Augusto Fernandes de Menezes Department of periodontology, School of Dentistry, University Center of State of Pará, Belém, Pará, Brazil
  • Paula Gabriela Faciola Pessoa de Oliveira Department of periodontology, School of Dentistry, University Center of State of Pará, Belém, Pará, Brazil

DOI:

https://doi.org/10.12974/2311-8695.2020.08.2

Keywords:

Platelet-rich fibrin, Gingival recession, Allografts.

Abstract

Gingival recession can be defined as the displacement of the marginal tissue apical to the cemento-enamel junction exposing the root surface of teeth. To restore the displaced tissue, grafts are used mainly to modify the periodontal biotype and reconstruct the gingival tissue and among graft types we mention autogenous, xenogenous and allogeneic. This paper aims to report a case of bilateral root coverage using acellular dermal matrix (ADM) graft and platelet-rich fibrin (L-PRF) membrane. Female patient, 27 years old, non-smoker and no previous medical conditions attended to a college dental clinic in northern Brazil with the main complaint of dental hypersensitivity. On intraoral exam it was observed gingival recessions stage II type 1 in teeth 13 and 23 due to orthodontic treatment. After preoperative exams and oral cavity adequacy, the recommended treatment was root coverage by Zucchelli & De Sanctis technique with autogenous graft. However due to the hard palate thin thickness and the patient's refusal to have a second postoperative area xenogenous and allogeneic were used. During the surgical procedure a coronally advanced flap without relaxing incisions were made and associated with L-PRF membrane in tooth 23 and ADM graft in tooth 13, then the coronal flap was fixed with sutures. We conclude that the use of L-PRF and ADM are viable techniques and with excellent predictability of success; both improved the range of keratinized mucosa and promoted clinical attachment level (CAL) increase. 

References

Pini Prato GP. Mucogingival deformities. Ann Periodontol. 1999; 4: 1-6. https://doi.org/10.1902/annals.1999.4.1.98

Cortellini P, Bissada NF. Mucogingival conditions in the natural dentition: Narrative review, case definitions, and diagnostic considerations. J Periodontol. 2018; 89(1): S204- S213. https://doi.org/10.1002/JPER.16-0671

Scheyer ET, Sanz M, Dibart S, Greenwell H, John V, Kim DM, et al. Periodontal soft tissue non-root coverage procedures: a consensus report from the AAP Regeneration Workshop. J Periodontol. 2015; 86(2 Suppl): S73-6. https://doi.org/10.1902/jop.2015.140377

Kassab MM, Cohen RE. The etiology and prevalence of gingival recession. J Am Dent Assoc. 2003; 134(2): 220-5. https://doi.org/10.14219/jada.archive.2003.0137

Serino G, Wennström JL, Lindhe J, Eneroth L. The prevalence and distribution of gingival recession in subjects with a high standard of oral hygiene. J Clin Periodontol. 1994; 21(1): 57-63. https://doi.org/10.1111/j.1600-051X.1994.tb00278.x

Cairo F, Nieri M, Cincinelli S, Mervelt J, Pagliaro U. The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: an explorative and reliability study. J Clin Periodontol. 2011; 38(7): 661-6. https://doi.org/10.1111/j.1600-051X.2011.01732.x

Miller PD Jr. A classification of marginal tissue recession. Int J Periodontics Restorative Dent. 1985; 5(2): 8-13.

Pini-Prato G. The Miller classification of gingival recession: limits and drawbacks. J Clin Periodontol. 2011; 38(3): 243-5. https://doi.org/10.1111/j.1600-051X.2010.01655.x

Kim DM, Neiva R. Periodontal soft tissue non-root coverage procedures: a systematic review from the AAP Regeneration Workshop. J Periodontol. 2015; 86(2 Suppl): S56-72. https://doi.org/10.1902/jop.2015.130684

Renkema AM, Fudalej PS, Renkema AA, Abbas F, Bronkhorst E, Katsaros C. Gingival labial recessions in orthodontically treated and untreated individuals: a case - control study. J Clin Periodontol. 2013; 40(6): 631-7. https://doi.org/10.1111/jcpe.12105

Renkema AM, Navratilova Z, Mazurova K, Katsaros C, Fudalej PS. Gingival labial recessions and the post-treatment proclination of mandibular incisors. Eur J Orthod. 2015; 37(5): 508-13. https://doi.org/10.1093/ejo/cju073

Zucchelli G, De Sanctis M. Treatment of multiple recessiontype defects in patients with esthetic demands. J Periodontol. 2000; 71(9): 1506-14. https://doi.org/10.1902/jop.2000.71.9.1506

Zucchelli G, Testori T, De Sanctis M. Clinical and anatomical factors limiting treatment outcomes of gingival recession: a new method to predetermine the line of root coverage. J Periodontol 2006; 77(4): 714-21. https://doi.org/10.1902/jop.2006.050038

Balderrama ÍF, Ferreira R, Rezende DRB, Nogueira ALRN, Greghi SLA, Zangrando MSR. Root coverage stability with acellular dermal matrix in multiple gingival recessions in esthetic zone: A clinical case report with 12-year follow-up. J Indian Soc Periodontol. 2019; 23(6): 584-588. https://doi.org/10.4103/jisp.jisp_582_18

Kim DM, Bassir SH, Nguyen, TT. Effect of gingival phenotype on the maintenance of periodontal health: An American Academy of Periodontology Best Evidence Review. Journal of periodontology. (2019)

Menceva Z, Dimitrovski O, Popovska M, Spasovski S, Spirov V, Petrushevska G. Free gingival graft versus mucograft: histological evaluation. Open access Macedonian journal of medical sciences, (2018); 6(4): 675. https://doi.org/10.3889/oamjms.2018.127

Heasman P. A, Holliday R, Bryant A, Preshaw P. M. Evidence for the occurrence of gingival recession and non‐carious cervical lesions as a consequence of traumatic toothbrushing. Journal of clinical periodontology (2015); 42: S237-S255. https://doi.org/10.1111/jcpe.12330

Cunha MJ, Esper LA, Sbrana MC, Cirino CC, Oliveira PG, de Almeida AL. Evaluation of the effectiveness of diode laser on pain and edema in individuals with cleft lip and palate submitted to secondary bone graft. Cleft Palate Craniofac J. 2013; 50(5): e92-7. https://doi.org/10.1597/11-281

İzol BS, Üner DD. A New Approach for Root Surface Biomodification Using Injectable Platelet-Rich Fibrin (I-PRF). Med Sci Monit. 2019; 26(25): 4744-4750. https://doi.org/10.12659/MSM.915142

Fathima KH, Harish VS. A comparison of efficiency of biopolymer and allograft matrix with autogenous gingival graft used in root coverage procedure. J Pharm Bioallied Sci. 2015; 7(Suppl 2): S695-9. https://doi.org/10.4103/0975-7406.163481

Costa PP, Alves LB, Souza SL, Grisi MF, Palioto DB, Taba M Jr, et al. Root Coverage in Smokers with Acellular Dermal Matrix Graft and Enamel Matrix Derivative: A 12-Month Randomized Clinical Trial. Int J Periodontics Restorative Dent. 2016; 36(4): 525-31. https://doi.org/10.11607/prd.2560

Joly JC, Carvalho AM, da Silva RC, Ciotti DL, Cury PR. Root coverage in isolated gingival recessions using autograft versus allograft: a pilot study. J Periodontol. 2007; 78(6): 1017-22. https://doi.org/10.1902/jop.2007.060428

Rodas MAR, Paula BL, Pazmiño VFC, Lot Vieira FFDS, Junior JFS, Silveira EMV. Platelet-Rich Fibrin in Coverage of Gingival Recession: A Systematic Review and Meta- Analysis. Eur J Dent. 2020; 27. https://doi.org/10.1055/s-0040-1701907

Moraschini V, Barboza Edos S. Use of Platelet-Rich Fibrin Membrane in the Treatment of Gingival Recession: A Systematic Review and Meta-Analysis. J Periodontol. 2016; 87(3): 281-90. https://doi.org/10.1902/jop.2015.150420

Downloads

Published

06-06-2020

How to Cite

Damião, A. C. N., Santos, G. F. dos, de Souza Fonseca, R. R. ., de Almeida Machado, L. F. ., de Menezes, S. A. F. ., & Pessoa de Oliveira, P. G. F. . (2020). Root Coverage Associated with Acellular Dermal Matrix and L-Prf in Bilateral Unitary Gingival Recessions – Case Report. The Journal of Dentists, 8, 6–10. https://doi.org/10.12974/2311-8695.2020.08.2

Issue

Section

Articles