EFFECTS OF TETRACYCLINE HCL CONDITIONING AND FIBRIN-FIBRONECTIN SYSTEM APPLICATION IN THE TREATMENT OF BUCCAL GINGIVAL RECESSION WITH GUIDED TISSUE REGENERATION

A SPLIT-MOUTH CLINICAL TRIAL was designed to evaluate the effect of tr eating deep wide buccal gingival recession with guided tissue regenera tion using expanded polytetrafluoroethylene membrane combined with tet racycline HCl (TTC) root conditioning and fibrin-fibronectin sealing s ystem (FFSS) application. Eight patients, aged 25 to 57 years, each pr esenting two similar mucogingival defects, were selected. The two bila teral recessions were randomly assigned in each patient to either test or control treatment procedure. After initial therapy, each patient w as examined for assessment of plaque, gingivitis, recession depth (RD) , probing depth (PD), probing attachment level (PAL), and keratinized tissue width (KT). The test procedure included the elevation of mucope riosteal flap at the buccal aspect of the alveolar process. The root w as debrided and demineralized with 100 mg/ml TTC solution for 4 minute s using a burnishing technique with cotton pellets. A teflon membrane was secured and a film of FFSS was applied between the membrane and th e root surface. The buccal flap was sutured to completely submerge the membrane. Control treatment included gingival flap surgery with barri er membrane alone. After 6 weeks, the membrane was removed. Healing wa s evaluated 6 months after surgery. Both test and control procedures r esulted in highly significant recession reduction (3.0 mm +/- 1.1 and 2.6 mm +/- 1.2, respectively) and attachment gain (3.6 mm +/- 1.7 and 2.6 mm +/- 1.1, respectively). Mean root coverage was of 67% in the TT C+FFSS treated sites and 60% in membrane-only treated sites. However, only treatment with TTC+FFSS significantly reduced PD and increased KT (P<0.05). When treatments were compared, changes in PD and PAL were s ignificantly greater in TTC + FFSS treated sites (P<0.05). These findi ngs suggest that guided tissue regeneration with barrier membrane is a predictable procedure to treat gingival recession. Clinical results a ppear to be enhanced by the additional application of fibrin-fibronect in glue to tetracycline treated roots.