Alkan Arzu, Keskiner Ilker, Yuzbasioglu Emir
Department of Periodontology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey.
J Periodontol. 2006 Aug;77(8):1446-51. doi: 10.1902/jop.2006.060021.
One of the main objectives of periodontal reconstructive surgery is the coverage of exposed roots that occur due to gingival recession. On some occasions, where a caries, root resorption, or amalgam restoration exists on the exposed root surface, the treatment planning becomes more complex. This case report describes the use of a subepithelial connective tissue graft (SCTG) on a resin ionomer-restored root surface to treat gingival recession that is complicated with the above-mentioned handicaps.
An amalgam restoration and carious lesion were removed following full-thickness flap reflection, and the cavity was restored with glass ionomer cement. An SCTG was placed onto the restoration, and the flap was coronally positioned. A porcelain crown restoration was performed 9 months after surgery.
At 3-, 6-, and 9-month follow-ups, probing depths were reduced and gain in attachment level was obtained with no clinical signs of inflammation in gingiva. Monthly periodontal controls revealed that creeping attachment had occurred on the restoration during the follow-up periods.
This single case report serves as a good example to show that SCTG can be successfully performed to treat gingival recession associated with a glass ionomer-restored root surface.
牙周重建手术的主要目标之一是覆盖因牙龈退缩而暴露的牙根。在某些情况下，当暴露的牙根表面存在龋齿、牙根吸收或汞合金修复体时，治疗计划会变得更加复杂。本病例报告描述了在树脂离子体修复的牙根表面使用上皮下结缔组织移植（SCTG）来治疗伴有上述障碍的牙龈退缩。
在全厚瓣翻瓣后去除汞合金修复体和龋损，并用玻璃离子水门汀修复窝洞。将SCTG置于修复体上，然后将瓣向冠方定位。术后9个月进行烤瓷冠修复。
在3个月、6个月和9个月的随访中，探诊深度减小，附着水平增加，牙龈无炎症的临床体征。每月的牙周检查显示，在随访期间修复体上出现了渐进性附着。
本单病例报告很好地表明，SCTG可成功用于治疗与玻璃离子体修复的牙根表面相关的牙龈退缩。
