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VOLUME 23 , ISSUE 1 ( January, 2022 ) > List of Articles

ORIGINAL RESEARCH

Treatment of Localized Gingival Recession Using Gingival Unit Grafts: An 18-month Follow-up Study

Poonam Agrawal, Neelima Katti, Devapratim Mohanty, Shib Shankar Pradhan, Subash Chandra Raj, Dharmashree Satyarup, Annuroopa Mahopatra, Peri Srivani

Keywords : Gingival recession, Gingival unit graft, Longitudinal studies

Citation Information : Agrawal P, Katti N, Mohanty D, Pradhan SS, Raj SC, Satyarup D, Mahopatra A, Srivani P. Treatment of Localized Gingival Recession Using Gingival Unit Grafts: An 18-month Follow-up Study. J Contemp Dent Pract 2022; 23 (1):49-55.

DOI: 10.5005/jp-journals-10024-3276

License: CC BY-NC 4.0

Published Online: 21-05-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Aim: The study aimed to longitudinally evaluate the efficacy of gingival unit grafts (GUGs), a modification of free gingival grafts, in the management of Miller's class I and class II recession defects in mandibular anterior region, over a period of 18 months. Materials and methods: 17 subjects with 21 recession defects in mandibular anterior region were treated using GUG. Clinical parameters of recession depth (RD), clinical attachment levels (CALs), and keratinized tissue width (KTW) were recorded at baseline, 1, 6, and 18 months. Patient-centered outcomes were measured using a visual analog scale (VAS) for pain and discomfort on 14th postoperative day and for treatment satisfaction at the end of 18 months. Results: There was a statistically significant improvement in RD, CAL, and KTW at 18 months when compared to baseline levels. A mean root coverage (MRC) percentage of 84.76 ± 11.79% was achieved at the end of 18 months. Patient-related outcomes for VAS for pain and discomfort as well as treatment satisfaction showed favorable results. Conclusion: GUG can be used as a predictable treatment modality for Miller's class I and class II recession defects in mandibular anterior region. The results obtained can be well maintained over 18-month period with optimal maintenance care. Clinical significance: The advantage of involving marginal gingiva in GUG results in a well-contoured graft, which increases the ease of adaptation and suturing. The biological characteristic of intact marginal vasculature results in early integration of graft into the recipient area and greater success in graft survival over denuded root surface, causing better long-term RC outcomes.


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  1. Glossary of periodontal terms-AAP Connect.
  2. Kehua Q, Yingying F, Hong S, et al. A cross-sectional study of dentine hypersensitivity in China. Int Dent J 2009;59(6):376–380. PMID: 20162951.
  3. Goutoudi P, Koidis PT, Konstantinidis A. Gingival recession: a cross-sectional clinical investigation. Eur J Prosthodont Restor Dent 1997;5(2):57–61. PMID: 9487812.
  4. Oliver RC, Brown LJ, Löe H. Periodontal diseases in the United States population. J Periodontol 1998;69(2):269–278. DOI: 10.1902/jop.1998.69.2.269.
  5. Pfeifer JS, Heller R. Histologic evaluation of full and partial thickness lateral repositioned flaps: a pilot study. J Periodontol 1971;42(6): 331–333. DOI: 10.1902/jop.1971.42.6.331.
  6. McGuire MK. Coverage of the denuded root surface using the free soft tissue autograft. J Am Dent Assoc 1990;121(2):277–279. DOI: 10.14219/jada.archive.1990.0244.
  7. Langer B, Langer L. Subepithelial connective tissue graft technique for root coverage. J Periodontol 1985;56(12):715–720. DOI: 10.1902/jop.1985.56.12.715.
  8. Prato GP, Tinti C, Vincenzi G, et al. Guided tissue regeneration versus mucogingival surgery in the treatment of human buccal gingival recession. J Periodontol 1992;63(11):919–928. DOI: 10.1902/jop.1992.63.11.919.
  9. Kassab MM, Badawi H, Dentino AR. Treatment of Gingival Recession. Dent Clin North Am 2010;54(1):129–140. DOI: 10.1016/j.cden.2009.08.009.
  10. Chambrone L, Sukekava F, Araújo MG, et al. Root-coverage procedures for the treatment of localized recession-type defects: a cochrane systematic review. J Periodontol 2010;81(4):452–478. DOI: 10.1902/jop.2010.090540.
  11. Nabers JM. Free gingival grafts. Periodontics 1966;4(5):243–245. PMID: 5223124.
  12. Camargo PM, Melnick PR, Kenney EB. The use of free gingival grafts for esthetic purposes. Periodontol 2000 2001;27:72–96. DOI: 10.1034/j.1600-0757.2001.027001072.x.
  13. Greenwell H, Fiorellini J, Giannobile W, et al.; Research, Science and Therapy Committee. Oral reconstructive and corrective considerations in periodontal therapy. J Periodontol 2005;76(9): 1588–1600. DOI: 10.1902/jop.2005.76.9.1588.
  14. Holbrook T, Ochsenbein C. Complete coverage of the denuded root surface with a one-stage gingival graft. Int J Periodontics Restorative Dent 1983;3(3):8–27. PMID: 6358084.
  15. Miller PD Jr. Root coverage using the free soft tissue autograft following citric acid application. III. A successful and predictable procedure in areas of deep-wide recession. Int J Periodontics Restorative Dent 1985;5(2):14–37. PMID: 3858263.
  16. Miller PD. Root coverage with the free gingival graft. Factors associated with incomplete coverage. J Periodontol 1987;58(10): 674–681. DOI: 10.1902/jop.1987.58.10.674.
  17. Allen AL. Use of the gingival unit transfer in soft tissue grafting : report of three cases. Int J Periodontics Restorative Dent 2004;24(2):165–175. PMID: 15119887.
  18. Schroeder HE, Listgarten MA. The gingival tissues: the architecture of periodontal protection. Periodontol 2000 1997;13:91–120. DOI: 10.1111/j.1600-0757.1997.tb00097.x.
  19. Kuru B, Yıldırım S. Treatment of localized gingival recessions using gingival unit grafts: a randomized controlled clinical trial. J Periodontol 2013;84(1):41–50. DOI: 10.1902/jop.2012.110685.
  20. Jenabian N, Bahabadi MY, Bijani A, et al. Gingival unit graft versus free gingival graft for treatment of gingival recession: a randomized controlled clinical trial. J Dent (Tehran) 2016;13(3):184–192. PMID: 28392815.
  21. Sriwil M, Fakher M, Hasan K, et al. Comparison of free gingival graft and gingival unit graft for treatment of gingival recession: a randomized controlled trial. Int J Periodontics Restorative Dent 2020;40(3):e103–e110. DOI: 10.11607/prd.4180.
  22. Dorfman HS, Kennedy JE, Bird WC. Longitudinal evaluation of free autogenous gingival grafts. A four year report. J Periodontol 1982;53(6):349–352. DOI: 10.1902/jop.1982.53.6.349.
  23. Matter J, Cimasoni G. Creeping attachment after free gingival grafts. J Periodontol 1976;47(10):574–579. DOI: 10.1902/jop.1976.47.10.574.
  24. Agudio G, Nieri M, Rotundo R, et al. Free gingival grafts to increase keratinized tissue: a retrospective long-term evaluation (10 to 25 years) of outcomes. J Periodontol 2008;79(4):587–594. DOI: 10.1902/jop.2008.070414.
  25. Löe H. The gingival index, the plaque index and the retention index systems. J Periodontol 1967;38(6):610–616. DOI: 10.1902/jop.1967.38.6.610.
  26. Lee YM, Kim JY, Seol YJ, et al. A 3-year longitudinal evaluation of subpedicle free connective tissue graft for gingival recession coverage. J Periodontol 2002;73(12):1412–1418. DOI: 10.1902/jop.2002.73.12.1412.
  27. Harris RJ, Miller LH, Harris CR, et al. A comparison of three techniques to obtain root coverage on mandibular incisors. J Periodontol 2005;76(10):1758–1767. DOI: 10.1902/jop.2005.76.10.1758.
  28. Nart J, Valles C. Subepithelial connective tissue graft in combination with a tunnel technique for the treatment of Miller Class II and III gingival recessions in mandibular incisors: clinical and esthetic results. Int J Periodontics Restorative Dent 2016;36(4):591–598. DOI: 10.11607/prd.2748.
  29. Berridge JP, Johnson TM, Lane JD, et al. Focus on epithelialized palatal grafts. Part 1: multiple adjacent recession defects in the mandibular anterior. Clin Adv Periodontics 2018;8(4):160–166. DOI: 10.1002/cap.10035.
  30. Matter J. Free gingival grafts for the treatment of gingival recession: a review of some techniques. J Clin Periodontol 1982;9(2):103–114. DOI: 10.1111/j.1600-051x.1982.tb01226.x.
  31. Miron RJ, Fujioka-Kobayashi M, Bishara M, et al. Platelet-rich fibrin and soft tissue wound healing: a systematic review. Tissue Eng-Part B Rev 2017;23(1):83–99. DOI: 10.1089/ten.TEB.2016.0233.
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