1996 ucla connective tissue-grafts
DESCRIPTION
UCLA perioTRANSCRIPT
TARRSON FAMILY ENDOWED CHAIR IN PERIODONTICS
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UCLA SCHOOL OF DENTISTRY
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PresentsPresentsDr. E. Barrie KenneyProfessor & ChairmanSection of Periodontics
E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
Tarrson Family Endowed Chair in Periodontics.
Professor and Chairman Division of Associated Clinical Specialties UCLA School of Dentistry
Connective Tissue Graft
Treatment of Gingival Recession
Esthetic Problem
Adequate Keratinized Gingiva
Adequate Keratinized Gingiva
Gingival Graft for Root Coverage or Gingival Graft and Coronally Repositioned Flap
Recession More than 2 mm.
Coronally Repositioned Semi-Lunar Flap
Lateral Sliding Flap
Adequate Adjacent Donor Site
Adequate Palatal Donor Site
Yes
No
YesYes
Yes
Yes
Yes
No
NoNo
No
No
3 Month Evaluation for Progression
Gingival Graft
Connective Tissue Graft
Coronally Repositioned
Flap with Membrane or
Emdogain
Treatment of Gingival Recession
Esthetic Problem
Adequate Keratinized Gingiva
Adequate Keratinized Gingiva
Gingival Graft for Root Coverage or Gingival Graft and Coronally Repositioned Flap
Recession More than 2 mm.
Coronally Repositioned Semi-Lunar Flap
Lateral Sliding Flap
Adequate Adjacent Donor Site
Adequate Palatal Donor Site
Yes
No
YesYes
Yes
Yes
Yes
No
NoNo
No
No
3 Month Evaluation for Progression
Gingival Graft
Connective Tissue Graft
Coronally Repositioned
Flap with Membrane or
Emdogain
Smoking and Root Coverage with Connective
Tissue GraftsSmoking may affect root coverage
outcome. A prospective clinical trial in humans.
Martins A.G. et alJ. Periodontol. 2004 75:586
• 18 Recessions in 15 Patients• 7 smokers, 8 non-smokers• Clinical evaluation at 30, 60, 90
and 120 days post surgery
Non Smokers Smokers
Percent Root Coverage74.73 58.84
Attachment Level Gain2.54 2.00
Root Resorption assosiated with a subepithelial connective tissue
graft:Clinical and histologic report of a case.
• 2 year post surgery• Clinically successful• Patient changed to full denture• Conventional surgery• 50% citric acid for 3 minutes
Int. J. Periodont. Rest. Dent. 2003, 4:391
Carnio J,Camargo P.M, Kenney E.B.
Connective Tissue Graft Plus Emdogain
Histological evaluation of 4 cases with root coverage following a connective tissue graft combined with an Enamel Matrix Derivative
Preparation
Carnio J, Camargo, P.M., Kenney, E.B., Scheak, R.K.
J. Periodontol. 2002 73:1534
• 4 upper teeth with Miller class II or III recession• Connective tissue graft plus Emdogain• Root treated with EDTA for 2 minutes• 2 sectioned at 6 months, 2 at 1 year• Light microscopy• Notch placed above bone crest
Gingival Recession
• All teeth obtained root coverage• Connective tissue adjacent to root• 1 case of new cementum after 6 months• No significant new bone formation• No long junctional epithelium
Original 6 months 1 year
4 0
6 2
5 1
6 3
6 MONTH
6 MONTH
1 YEAR
A l l o D e r m
• Processed human skin• Developed in 1994 for burns• Cells removed• Antiviral treatment• Freeze-dried• Dermal side red, shiny
• Basement membrane side white, rough and dull• Collagen elastin and ground substance• No epithelium• Vessels intact• All donors
Negative for HIV, hepatitis B & C, syphilis
A short-term and long-term comparison of root coverage
with an acellular dermal matrix and a subepithelial graft
Harris RJ,J Periodont 2004, 75:734
• 25 patients
• Evaluated at 12 to 13 weeks and 48 to 49 months
• Non-random assignment
12 - 13 weeks 48 – 49 months
AlloDerm 93.4 65.8
Connective Tissue Graft 96.6 97.0
P e r c e n t a g e o f R o o t C o v e r a g e
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UCLA SCHOOL OF DENTISTRY
