Center for Advanced Dental Research and Care, Department of Dentistry, Mount Sinai Hospital and Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
Sinai Health System, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Clin Adv Periodontics. 2020 Dec;10(4):200-203. doi: 10.1002/cap.10094. Epub 2020 Apr 7.
Although gingival fenestrations (GFs) occur with relative infrequency, their actual incidence is thought to be much higher. Furthermore, if left untreated, these mucogingival defects can lead to unfavorable sequelae which can compromise the esthetics and stability of the teeth affected. Most GFs require surgical treatment for closure. Previously reported modalities of treatment include connective tissue grafting, acellular dermal matrix allograft, and pedicle flap approaches. This case demonstrates the first documented use of a dehydrated amnion-chorion membrane (dHACM) to treat GF.
A surgical approach involving a double pedicle flap and dHACM with 15 months follow-up is described. Following gentle cleansing of the defect and careful split-thickness elevation of a double pedicle flap, the area of exposure fenestration was covered with dHACM. The overlying flap was then closed carefully to completely cover the dHACM. The case presented shows a successful clinical outcome as characterized by successful closure of the fenestration defect with nice tissue maturation.
The technique described in this case report demonstrates that GFs can be successfully treated with a periodontal plastic surgical approach using dHACM with minimal patient discomfort.
尽管牙龈开窗（GFs）相对少见，但据认为其实际发生率要高得多。此外，如果不进行治疗，这些黏骨膜缺损可能会导致不良后果，从而影响受影响牙齿的美观和稳定性。大多数 GFs 需要手术关闭。以前报道的治疗方法包括结缔组织移植、脱细胞真皮基质同种异体移植物和带蒂瓣方法。本病例首次证明了使用脱水羊膜-绒毛膜膜（dHACM）治疗 GFs。
描述了一种涉及双蒂瓣和 dHACM 的手术方法，并进行了 15 个月的随访。在对缺损进行温和清洁并小心地进行双蒂瓣的全厚层掀起后，用 dHACM 覆盖暴露的开窗区域。然后仔细关闭覆盖瓣以完全覆盖 dHACM。本病例表现出成功的临床结果，特征为开窗缺陷成功闭合，组织成熟良好。
本病例报告中描述的技术表明，使用 dHACM 通过牙周整形手术方法可以成功治疗 GFs，患者不适感最小。
