Vijayendra R, Suchetha A, Jaganath Sharadha, Gurfan Khalid
Department of Periodontics, D A Pandu Memorial R V Dental College, Bangalore, India.
Indian J Dent Res. 2011 May-Jun;22(3):478-81. doi: 10.4103/0970-9290.87075.
Gingival recession is a multifaceted problem, for which several treatment options are available. Both epithelized and subepithelial connective tissue grafts offer predictable solutions for the treatment of gingival recession.The case report involved a 30-year-old man with gingival recession of 8 mm on 41 (Miller's class II recession). Before surgery, full mouth scaling and polishing were performed. Recession height, width, probing depth, clinical attachment level (CAL), and width of the attached gingiva (WAG) were measured at the baseline, two months postoperatively, and six months postoperatively. Four weeks after scaling, the first step of increasing the width of the attached gingiva was carried out, using a free gingival graft. Two months after this step, the subepithelial connective tissue was harvested from the palate and placed in relation to 41, to cover the residual defect.Two months postoperatively, there was a 3 mm gain in WAG and 35% root coverage. Six months postoperatively there was a significant increase in WAG, CAL; and reduction in height and width of recession (root coverage achieved was 75%). These results suggested that this two-stage surgical procedure could be successful for root coverage in case of deep recession and lack of attached gingiva in the mandibular anterior region.
牙龈退缩是一个多方面的问题，针对此有多种治疗选择。上皮化和上皮下结缔组织移植都为牙龈退缩的治疗提供了可预测的解决方案。该病例报告涉及一名30岁男性，41号牙处牙龈退缩8毫米（米勒II类退缩）。手术前，进行了全口洁治和抛光。在基线、术后两个月和术后六个月测量退缩高度、宽度、探诊深度、临床附着水平（CAL）以及附着龈宽度（WAG）。洁治四周后，使用游离龈瓣移植进行增加附着龈宽度的第一步操作。此步骤两个月后，从腭部获取上皮下结缔组织并放置于41号牙处，以覆盖残余缺损。术后两个月，WAG增加3毫米，牙根覆盖率达35%。术后六个月，WAG、CAL显著增加；退缩高度和宽度减小（牙根覆盖率达75%）。这些结果表明，对于下颌前部区域存在深度退缩且缺乏附着龈的情况，这种两阶段手术方法在牙根覆盖方面可能会取得成功。
