INFORMATIVE ARTICLES
Covering Denuded Maxillary Root Surfaces With the Subepithelial Connective Tissue Graft
By Robert A. Levine, D.D.S., P.C.
(Compendium 1991, Contin Educ Dent, Vol. XII, No. 8, Aug. 1991)
The subepithelial connective tissue graft is an esthetic gingival grafting procedure used to cover denuded single and multiple surfaces primarily of maxillary anterior and bicuspid teeth. A clinical study of 10 private practice periodontal patients is presented with results of 97.04% root coverage achieved on average in 21 sites treated, which had an average recession of 3.86 mm. The technique and the rational for its use are presented with documented case report results.
Introduction
A current goal in dentistry in general and periodontics in particular is to maximize our esthetic results. Miller and Holbrook and Ochsenbein reported on various surgical techniques to attain the cosmetic result of root coverage, using the free soft-tissue autograft technique with and without the use of critic acid root conditioning, respectively. Levine reported achieving similar results using surgical techniques described by Miller and Holbrook and Ochsenbein. The result has been extremely predictable, gaining 100 % root coverage on most teeth (indicated to be) treated in the anterior mandibular region of the mouth. However, the technique has not been very predictable when trying to cover very wide and deep areas of recession (greater than 3 mm in height and width) that are often present in the maxillary jaw where the mesiodistal and apicocoronal distances to cover are significantly greater than those in the lower anterior region. In addition, the free soft-tissue autograft technique for root coverage has its limitations in the treatment of multiple areas of recession. Holbrook and Ochsenbein reported that 50 teeth with recessions less than 3 mm had close to 96% total root coverage...
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