RESORBABLE BARRIER AND ENVELOPE FLAP SURGERY IN THE TREATMENT OF HUMAN GINGIVAL RECESSION DEFECTS - CASE-REPORTS

The present case report evaluates the treatment outcome following muco gingival surgery combined with a bioresorbable barrier in gingival rec ession defects In humans, A total of 11 buccal, Miller Class I or II, gingival recession defects in 6 patients were consecutively treated. T he exposed root surface was ultrasonically scaled and conditioned with a tetracycline HCl solution (10 mg/ml) for 4 min, A buccal full/split thickness envelope flap was then elevated, and a bioresorbable matrix barrier was positioned to completely cover the exposed root surface a nd surrounding bone margins, A flap sas then positioned at or slightly coronal to its original position, In all cases, a variable amount of membrane was intentionally left uncovered on the exposed root surface, Clinical recordings, assessed presurgery and at 6 months postsurgery, included defects-specific plaque and gingival scores, recession depth (RD), probing depth (PD), clinical attachment level (CAL) and keratin ized tissue width (KT). Immediately postsurgery, and at weeks 1, 2, 4, 6 and 8 postsurgery the location of gingival margin or granulation ti ssue covering the previously exposed root surface was recorded, as wel l as the extent of barrier exposure. Statistical analysis showed that RD decreased from 2.3 +/- 0.2 mm presurgery to 0.8 +/- 0.5 mm at 6 mon ths postsurgery (p = 0.001), representing a mean root coverage of 65 % (range: 40 - 100%), CAL gain paralleled RD reduction (1.5 +/- 0.5 mm: p = 0.0009), while KT showed a slight increase (0.3 +/- 0.6 mm) at 6 months postsurgery. Results indicate that clinical improvement of ging ival recession defects may be achieved by means of a barrier-supported envelope technique, The bioresorbable matrix barrier represented an e ffective scaffold to support the reconstruction of the mucogingival un it.