Fogorvosi szemle, 2017 (110. évfolyam, 1-4. szám)
2017-06-01 / 2. szám
62 FOGORVOSI SZEMLE ■ 110. évf. 2. sz. 2017. Kövér K, Horváth A, Gera I The Creeping Attachment Phenomenon Review of the Literature and Case Series The occurrence of creeping attachment (CA) has been shown both with autogenous epithelial (eCTG) and subepithelial connective tissue masticatory mucosa grafts (sCTG). The purpose of this case series was to show the process and the occurrence of CA in the short and also in the long term. The first case with a deep Miller class III gingival recession and frenulum pull presents the result of a corrective mucosal plastic surgery with eCTG aimed at deepening the vestibulum. This resulted not only in wider kreatinised gingiva (KG) but also in a partial coverage of the denuded root, therefore the planned second coronally advanced flap surgery became unnecessary. In addition, CA reduced the recession to 0,5 mm (approx. 95% coverage) in three years following surgery. The second case follows up the healing/maturation process of a Miller Class II recession with extended cervical abrasion. The surgery with sCTG improved the preoperative 9 mm gingival recession to 3,5 mm resulting in only a 60% root coverage. However, 95% root coverage and improved biotype was achieved over 3 years. The 3rd and 4th cases follow up the result of mucogingival surgeries with sCTG and eCTG respectively over several years. The fresh suboptimal clinical results underwent marked improvement throughout the follow-up period. Nevertheless, 10 years after surgery complete root coverage was achieved in the Miller class II case and partial root coverage alongside marked apical widening of the KG was observed at the Miller class III defects. CA seems to occur commonly, in addition according to the authors’ experiences and the presented cases CA does not restrict to the first two postoperative years, but continues over the years. Nevertheless, complete root coverage following CA is not predictable in Miller Class III defects. Key words: creeping attachment (CA), connective tissue grafts, subepithelial connective tissue grafts, biotype, root coverage, case follow up
