Therapeutic efficacy of connective tissue autotransplants with periosteum and platelet rich plasma in the management of gingival recession

Bojan Jovicic, Zoran Lazic, Milica Nedic, Stevo Matijevic, Aleksandra Gostovic-Spadijer
2013 Vojnosanitetski Pregled  
Background/Aim. Gingival recession progression in clinical practice has influenced the development of various surgical procedures and techniques for solving esthetic imperfections and subjective difficulties coused by gingival recession. The aim of this study was to verify efficacy of surgical procedures and to compare both of surgical procedures through the keratinized tissue width. Methods. The study included 20 teeth with gingival recesion, Müller class I and II. Ten teeth with gingival
more » ... with gingival recession were treated with connective tissue autotransplants with periosteum in combination with coronary guided surgical flap (CTG group). On the contralateral side 10 teeth with gingival recession were treated with the same surgical procedures but in combination with platelet-rich plasma (CTG-PRP group). We measured the keratinized tissue width. For statistical significance we used the Student's t-test. Results. The study reveled a statistical significance in reducing vertical deepress of recession by both used treatments. Root deepness in CTG and CTG-PRP group was 90% and 93.5%, respectively. With both surgical techniques we achieved larger zone of keratinized gingiva but with a wide zone of keratinized tissue in CTG -the PRP group. Conclusion. The concept regeneration technique with PRP and with the stimulating influence of platele activated growth factors results in the regeneration of deep periodontal tissue as an important prerequisite for the successfull treatment of gingival recession. Apstrakt Uvod/Cilj. Sve ve a zastupljenost gingivalnih recesija u svakodnevnoj klini koj praksi uslovila je zahteve za što efikasnijim rekonstruktivnim hirurškim procedurama, u cilju rešavanja estetskih nedostataka i subjektivnih tegoba usled povla enja gingive. Cilj rada bio je da se uporedi efikasnost le enja autotransplantatom vezivnog tkiva (ATVT) sa periostom i plazme oboga ene trombocitima (PRP) sa ATVT sa periostom, ali bez PRP, na širinu keratinizirane gingive. Metode. Studijama je bilo obuhva eno 20 zuba sa recesijama gingive klase I i II prema Mülleru. U toku terapije 10 recesija le eno je ATVT sa periostom u kombinaciji sa koronarno pomerenim režnjima (ATVT grupa). Na kontralateralnoj strani, isti broj recesija le en je ATVT uz koronarno pomeren režanj i uz primenu PRP (PRP + ATVT grupa). Od klini kih parametara pra ena je širina keratinizovane gingive kao pokazatelj pokrenutih regenerativnih procesa. U statisti koj obradi rezultata koriš en je Studentov t-test. Rezultati. Analizom klini kih parametara ustanovljeno je statisti ki zna ajno proširenje zone keratinizirane gingive, što je od izuzetnog zna aja za regeneraciju s tim što je proširenje bilo izraženije u ATVT + PRP grupi. Procentualno gledano, prekrivenost korena u ATVT grupi iznosila je 90%, a u ATVT + PRP grupi 93,5%. Zaklju ak. Primenom koncepta aktivne regeneracije odnosno primenom PRP i stimulativnim dejstvom aktiviranih faktora rasta iz trombocita, postiže se regeneracija dubljeg periodontalnog tkiva što je bitan preduslov za uspešno zbrinjavanje recesije gingive. Klju ne re i: gingiva, povla enje; stomatologija, operativna; transplantacija, autologa; plazma bogata trombocitima; le enje, ishod. Volumen 70, Broj 7 VOJNOSANITETSKI PREGLED Strana 665 Jovi i B, et al. Vojnosanit Pregl 2013; 70(7): 664-669.
doi:10.2298/vsp1307664j pmid:23984615 fatcat:n3dgzqhtqbblxp6uuauutt3wta