Periodontal plastic surgery: gingival recession coverage with a xenogenic collagen matrix
The American Academy of Periodontology defines the gingival recession as the displacement of marginal tissue apical to the cemento-enamel junction (CEJ). The most common factors causing gingival recession are: wrong use of the toothbrush (abrasive trauma), thin biotype, periodontitis, orthodontic factors, piercings and coronal insertion of the labial frenulum.
A 37-year-old patient, non-smoker and with absence of relevant systemic pathologies presented to the dental office with an esthetic gingival deficit and dentinal sensibility of the elements #16, #22, #24, #25 and #26 FDI. The causes of this recession are probably due to an incorrect use of the toothbrush.
The patient presented also a thin biotype and was extremely anxious, but with high esthetic and functional demands.
The objective of the treatment was to remove the dentinal sensibility and the esthetic deficit, by executing a periodontal plastic surgery. Root coverage was obtained with the use of CreosTM mucogain, a xenogenic collagen matrix.
Due to presence of single recessions on the #16 FDI, on the #22 FDI. and multiple recessions on the neighboring teeth #24, #25 and #26 FDI it was decided to go for three different flap designs to achieve root coverage. Moreover, due to the patient's thin gingival biotype, high anxiety status and esthetic expectations it was decided to use the xenogenic collagen matrix CreosTM mucogain as an alternative to the Connective Tissue Graft (CTG).
Literature has proven the increased predictability of root coverage when using bilaminar techniques instead of the Coronally Advanced Flap (CAF) alone (Cairo e coll. 2014; Chambrone 2012; Buti e coll. 2013; Pini Prato e coll. 2014).
The use of a xenogenic collagen matrix as alternative to the CTG for root coverage of Miller's class I recessions, represents an efficient and predictable solution. Not only the post-op morbidity decreases for the patient, but also the length of the surgery and the stress on the practicioner decrease.
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