Periodontal regeneration in gingival recession defects

Surgical treatment of gingival recession defects aims at obtaining soft tis sue coverage of exposed root surfaces and/or augmentation of gingival tissu e dimensions. A variety of protocols have been developed to manage these cl inical problems, Since one goal of periodontal therapy is the regeneration of the lost attachment apparatus of the tooth, full restoration of defect s hould be accomplished following mucogingival procedures. This implies regen eration of all peri odontal structures, including formation of new cementum with inserting connective tissue fibers, alveolar bone regeneration and re creation of a functional and aesthetic morphology of the mucogingival compl ex. Animal and human histological studies have shown that healing at gingiva-ro ot interface following pedicle flaps or free soft tissue grafts generally i ncludes a long junctional epithelium with varying amounts of a new connecti ve tissue attachment in the most apical aspect of the covered root surface, Limited bone regeneration has been observed. Adjunctive use of root condit ioning agents and cell excluding, wound-stabilizing devices may amplify reg enerative outcomes. Changes in the amount of keratinized tissue, which can significantly affect the aesthetic outcome of treatment, have been shown to depend on the interactions among various tissues involved in the healing p rocess and the selected surgical procedure.