Fogorvosi szemle, 2011 (104. évfolyam, 1-4. szám)

2011-03-01 / 1. szám

FOGORVOSI SZEMLE

104. évf. 1.SZ. 2011.

25

fogmosási technikájától és plakk-kontrolljától. Az alkalmazott anyagoktól függetlenül a ma alkalmazott műtéti technikák a feszes íny kiszélesítését, és sekély residualis tasakkal társuló teljes vagy részleges gyökér fedését eredményezik. Irodalmi adatok szerint a technikáktól függően tartósan legjobb esetben is csupán 80-90%-os fognyaki fedés érhető el [34], Hosszú távú teljes gyökérfedésről csupán az esetek 28-61 %-ban számoltak be [34-38], Úgy tűnik, hogy a subepithelials kötőszöveti lebennyel kombinált koronálisan elcsúsztatott lebenyek, különböző biológiai regeneratív anyagokkal kombinálva jobb gyökérfedési értékeket adnak, mint a klasszikus epithelializált szabad ínylebeny-műtétek, és lényegesen jobb az esztétikai hatásuk is [24- 29]. Ezért a klasszikus epithelializált kötőszöveti grafttal végzett plasztikai műtétek indikációs köre egyre jobban beszűkül [39]. Esetünk azt látszik igazolni, hogy a viszonylag széles Miller-I típusú ínyrecessio esetében domború fognyakon a ZMD-mal kombinált kötőszöveti szabad lebeny átültetésével közel 100%-os fedés érhető el. Azonban a jövő dönti el, hogy hosszú távon mennyire volt sikeres a műtét.

Irodalom

1. Glossary of periodontal terms, 4th ed. Chicago: The American Academy of Periodontology; J Periodontol (special issue) 1992, 63.

2. Seichter U: Root surface caries: A critical literature review. J Am Dent Assoc 1987; 115:305-310.

3. Miller Pd Jr: A classification of marginal tissue recession. Int J Periodont Restor Dent 1985; 5:9-13.

4. Staffileno H: Management of gingival recession and root exposure problems associated with periodontal disease. Dental Clin North Amer 1964; 3:111-120.

5. Pfeifer J, Heller R: Histologic evaluation of full and partial thickness lateral repositioned flaps. A pilot study. J Periodontol 1971; 42: 331-333.

6. Cohen DW , Ross SE: The double papillae repositioned flap in periodontal therapy. J Periodontol 1968; 39:65.

7. Baldi C, Pini-Prato G, Pagliaro U és mtsai: Coronally advanced flap procedure for root coverage. Is flap thickness a relevant predictor to achieve root coverage? A 19-case series. J Periodontol 1999; 70:1077-1084.

8. Tarnow DP: Semilunar coronally positioned flap. J Clin Periodontol 1986; 13:182-185.

9. Haghighat K: Modified semilunar coronally advanced flap. J Periodontol 2006; 77:1274-1279.

10. Nabers J: Free gingival grafts. Periodontics 1966; 4: 243-245.

11. Sullivan HC, Atkins JC: Free autogenous gingival grafts, Part I: principles of successful grafting. Periodontics 1968a; 6: 121-129.

12. Sullivan HC, Atkins JC: Free autogenous gingival grafts. III. Utilization of grafts in the treatment of gingival recession. Periodontics 1968b; 6: 152-160.

13. Langer B, Calagna L: The subepithelial connective tissue graft. J Prosthet Dent 1980; 44: 363

14. Langer B, Calagna L: The subepithelial connective tissue graft. A new approach to the enhancement of anterior cosmetics. Int J Periodontics Restorative Dent 1982; 2: 22-33.

15. Langer B, Langer L: Subepithelial connective tissue graft technique for root coverage. J Periodontol 1985; 56:715.

16. Raetzke PB: Covering localized areas of root exposure employing the “envelope” technique. J Periodontol 1985; 56: 397-402.

17. Zucchelli G, DE Santics M: Treatment of multiple recession-type defects in patients with esthetics demands. J Periodontol 2000; 71: 1506-1514.

18. Allen AL: Use of the supraperiosteal envelope in soft tissue grafting for root coverage. II. Clinical results. Int J Periodontics Restorative Dent 1994; 14: 302-315.

19. Azzi R, Etienne D, Sauvan JL, Miller Pd: Root coverage and papilla reconstruction in Class IV recession: a case report. Int J Periodontics Restorative Dent 1999; 19: 449-455.

20. Zabalequi I, Sicilia A, Cambra J És mtsai: Treatment of multiple adjacent recessions with the tunnel subepithelial connective tissue graft: a clinical report. Int J Periodontics Restorative Dent 1999; 19: 199-206.

21. Tözüm TF, Dini FM: Treatment of adjacent gingival recessions with subepithelial connective tissue grafts and the modified tunnel technique. Quintessence Int. 2003; 34: 7-13.

22. Cangini F, Cornelini R, Andreana S: Simultaneous treatment of multiple, bilateral, deep buccal recession defects with bioabsorbablebarrier membranes: a case report. Quintessence Int. 2003; 34: 15-18.

23. Gupta R, Pandit N, Sharma M: Clinical evaluation of a bioresorbable membrane (polyglactin 910) in the treatment of Miller type II gingival recession. Int J Periodontics Restorative Dent 2006; 26: 271- 277.

24. Sculean A, Donos N, Brecx M, Karring T, Reich E: Healing of fenestration-type defects following treatment with guided tissue regeneration or enamel matrix proteins. An experimental study in monkeys. Clin Oral Invest 2000; 4: 50-56.

25. Sallum EA, Casati MZ, Caffesse RG és mtsai: Coronally positioned flap with or without enamel matrix protein derivative for the treatment of gingival recessions. Am J Dent 2003; 16: 287-291.

26. Sallum EA, Pimentel SP, Saldanha JB és mtsai: Enamel matrix derivative and guided tissue Pregeneration in the treatment of dehiscence-type defects: a histomorphometric study in dogs. J Periodontol 2004; 75: 1357-1363.

27. Del Pizzo M, Zucchelli G, Modica F, Villa R, Debernardi C: Coronally advanced flap with or without enamel matrix derivative for root coverage: a 2 year study. J Clin Periodontol 2005; 32: 1181-1187.

28. Ofer M, Artzi Z, Sculean A, Tal H és mtsai: Comparative study of 2 root coverage procedures: a 24-month follow-up multicenter study. J Periodontol 2006; 77: 195-202.

29. Aroca S, Keglevich T, Barbiéri B, Gera I, Etienne D: Clinical Evaluation of a Modified Coronally Advanced Flap Alone or in Combination With a Platelet-Rich Fibrin Membrane for the Treatment of Adjacent Multiple Gingival Recessions: A 6-Month Study. J Periodontol 2009; 80: 244-252.

30. Henderson RD, Greenwell H, Drisko C, Regennitter FJ és mtsai: Predictable multiple site root coverage using an acellular dermal matrix allograft. J Periodontol 2001; 72: 571-582.

31. Hurzeler MB, Weng D: A single incision technique to harvest subepithelial connective tissue grafts from the palate. Int J Periodontics Restorative Dent 1999; 19: 279-287.

32. Borghetti A, Louise F: Controlled clinical evaluation of the subpedicle connective tissue graft for the coverage of gingival recession. J Periodontol 1994; 65: 1107-1112.

33. Zuhr O, Fickl S, Wachtel H, Bolz W, Hürzeler MB: Covering of gingival recessions with a modified microsurgical tunnel technique: case report. Int J Periodontics Restorative Dent 2007; 27: 457-463.

34. Wennstrom JL, Zucchelli G: Increased gingival dimensions. A significant factor for successful outcome of root coverage procedures? A 2-year prospective clinical study. J Clin Periodontol 1996; 23: 770-777.

35. Bouchard P, Malet J, Borghetti A: Decision-making in aesthetics: root coverage revisited. Periodontology 2000 2001; 27: 97-120.

36. Trombelli L, Tatakis Dn, Scabbia A, Zimmerman GJ: Comparison of mucogingival changes following treatment with coronally positioned flap and guided tissue regeneration procedures. Int J Periodontics Restorative Dent 1997; 17: 448-455.

37. Roccuzzo M, Bunino M, Needleman I, Sanz M: Periodontal plastic