Why
graft?
To decrease tooth mobility and increase
patient security
To
bide time during the mixed dentition stage and facilitate
management of the mucogingival problem related to tooth
malposition
To thicken thin keratinised tissue prior to
extensive arch expansion or proclination pre-surgery as a
preventive measure
Gingival recession strongly correlates with:
Bony dehiscences,
The position of the root in the arch
Soft
tissue thickness
Predictability of
modalities for root coverage
| |
Complete root coverage |
| |
Number of
studies |
Mean % teeth |
Range |
|
Rotational |
1 |
43% |
|
|
coronally |
5 |
58% |
24-95% |
|
GTR |
4 |
30% |
0-42% |
|
CT graft |
9 |
66% |
27-89% |
|
Free gingival graft |
9 |
57% |
0-90% |
(Adapted from Wennstron
& Pini Prato 1997)
Comparison study of stability
of lateral sliding flaps and coronally positioned flap for
localised recession similar results, stable after 3 years (Cuinard
and Caffesse 1978)
Miller Class I (1oo%) and II
(85%) defects expect average 3.79mm (Miller PD 1985)
Stability
- 70% of all denuded root surfaces with free gingival grafts
remained covered with no pocket formation (Bernimouelin et al
1975)
Ct grafts study 60 mo duration, 85% coverage(Paolantonio et al
1997)
Some suggestion that submucosa in CT graft
may act like a barrier membrane to CT and aid
regeneration
May be enhanced by conditioning
the root surface
Healing is by long junctional epithelial attachment
and connective tissue attachment
Pre-Grafting
Post-Grafting
Soft tissue is harvested from the palate
