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A novel approach in root coverage - Coronally repositioned flap with GTR membrane and frenotomy.

Patil VA, Patil ST - J Indian Soc Periodontol (2013)

Bottom Line: Vertical osseous defect along with Millers class I gingival recession was seen after initial therapy.Complete root coverage was achieved over the maxillary central incisor that initially presented with Miller's class I gingival recession along with radiographic bone fill of the osseous defect.This case report shows the possibility of applying GTR-based root coverage procedure using coronally advanced flap combined with frenotomy to treat Millers class I gingival recession.

View Article: PubMed Central - PubMed

Affiliation: Department of Periodontology, HKES's S. Nijalingappa Institute of Dental Sciences and Research, Gulbarga, Karnataka, India.

ABSTRACT
This case report describes a guided tissue regeneration (GTR) based root coverage procedure over maxillary central incisor using coronally advanced flap with simultaneously performed frenotomy. The patient was a 32-year-old female with chief complaint of gingival enlargement in relation to 11. Based on overall findings it was diagnosed as a case of inflammatory gingival enlargement. Vertical osseous defect along with Millers class I gingival recession was seen after initial therapy. GTR-based root coverage procedure using coronally advanced flap with simultaneously performed frenotomy was planned. Complete root coverage was achieved over the maxillary central incisor that initially presented with Miller's class I gingival recession along with radiographic bone fill of the osseous defect. This case report shows the possibility of applying GTR-based root coverage procedure using coronally advanced flap combined with frenotomy to treat Millers class I gingival recession.

No MeSH data available.


Related in: MedlinePlus

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Figure 9: After suturing

Mentions: At the time of surgery, the denuded root surface of 11 intended for root coverage was thoroughly root planed. A full thickness trapezoidal flap was prepared by giving a horizontal incision extending from the distal surface of 12 to the distal surface of 21, at the level of CEJ. Two vertical releasing incisions were given along the distal line angle of 12 and mesial line angle of 21. Crevicular incision was given to connect the horizontal and vertical releasing incisions. Full thickness flap was elevated 3-4 mm apical to the crest of osseous dehiscence; partial thickness flap was prepared thereafter [Figure 4]. Epithelial tissue in the interdental papillary area was debrided. Root planning was repeated and an odontoplastic procedure was performed in which the root was made concave to ensure regeneration space. The surgical site was degranulated and bioactive osseous graft was placed in relation to 11. GTR membrane was bent in a tent like fashion with a suture [Figure 5] and placed over the denuded root surface. A sling suture was used to stabilize the membrane against the root surface [Figure 6]. Before advancing the flap in a coronal direction, frenotomy was performed using no 15 blade to eliminate positive frenal pull [Figures 7 and 8]. The flap was displaced coronally until the flap covered the membrane completely, so as to avoid the exposure of the membrane and sutured using a sling suture [Figure 9].


A novel approach in root coverage - Coronally repositioned flap with GTR membrane and frenotomy.

Patil VA, Patil ST - J Indian Soc Periodontol (2013)

After suturing
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3713764&req=5

Figure 9: After suturing
Mentions: At the time of surgery, the denuded root surface of 11 intended for root coverage was thoroughly root planed. A full thickness trapezoidal flap was prepared by giving a horizontal incision extending from the distal surface of 12 to the distal surface of 21, at the level of CEJ. Two vertical releasing incisions were given along the distal line angle of 12 and mesial line angle of 21. Crevicular incision was given to connect the horizontal and vertical releasing incisions. Full thickness flap was elevated 3-4 mm apical to the crest of osseous dehiscence; partial thickness flap was prepared thereafter [Figure 4]. Epithelial tissue in the interdental papillary area was debrided. Root planning was repeated and an odontoplastic procedure was performed in which the root was made concave to ensure regeneration space. The surgical site was degranulated and bioactive osseous graft was placed in relation to 11. GTR membrane was bent in a tent like fashion with a suture [Figure 5] and placed over the denuded root surface. A sling suture was used to stabilize the membrane against the root surface [Figure 6]. Before advancing the flap in a coronal direction, frenotomy was performed using no 15 blade to eliminate positive frenal pull [Figures 7 and 8]. The flap was displaced coronally until the flap covered the membrane completely, so as to avoid the exposure of the membrane and sutured using a sling suture [Figure 9].

Bottom Line: Vertical osseous defect along with Millers class I gingival recession was seen after initial therapy.Complete root coverage was achieved over the maxillary central incisor that initially presented with Miller's class I gingival recession along with radiographic bone fill of the osseous defect.This case report shows the possibility of applying GTR-based root coverage procedure using coronally advanced flap combined with frenotomy to treat Millers class I gingival recession.

View Article: PubMed Central - PubMed

Affiliation: Department of Periodontology, HKES's S. Nijalingappa Institute of Dental Sciences and Research, Gulbarga, Karnataka, India.

ABSTRACT
This case report describes a guided tissue regeneration (GTR) based root coverage procedure over maxillary central incisor using coronally advanced flap with simultaneously performed frenotomy. The patient was a 32-year-old female with chief complaint of gingival enlargement in relation to 11. Based on overall findings it was diagnosed as a case of inflammatory gingival enlargement. Vertical osseous defect along with Millers class I gingival recession was seen after initial therapy. GTR-based root coverage procedure using coronally advanced flap with simultaneously performed frenotomy was planned. Complete root coverage was achieved over the maxillary central incisor that initially presented with Miller's class I gingival recession along with radiographic bone fill of the osseous defect. This case report shows the possibility of applying GTR-based root coverage procedure using coronally advanced flap combined with frenotomy to treat Millers class I gingival recession.

No MeSH data available.


Related in: MedlinePlus