periodontology
Minimally Invasive Coronally Advanced Tunnel A Novel Surgical Technique for Treatment of Multiple Recession Defects: A Case Series Joann Pauline George, M.D.S.; Divya Khanna, B.D.S., M.D.S.
ABSTRACT Perio-plastic surgeries are a continuously evolving and expanding field of research. A multitude of options are available for root coverage. Connective tissue grafts are the gold standard but have limitations, including patient morbidity, invasiveness and scar formation. The aim of this study is to evaluate the effectiveness of a novel minimally invasive coronally advanced tunnel (MI-CAT) technique for treatment of multiple recession-type defects (MRTD). The technique involves a muco-periosteal tunnel and stabilization of the advanced gingival margin by using orthodontic buttons as anchor units for two weeks postsurgery. After six months, enhanced root coverage (92.28%), excellent esthetics and significant improvement in periodontal parameters were achieved. The results indicate that the MI-CAT technique proved to be effective, minimally invasive and a predictable option for treatment of MRTD.
Gingival recession is a frequent finding, with an average 1 mm of recession in approximately 80% of the adult population.[1] The term denotes the oral exposure of root surfaces due to displacement of the gingival margin apical to the cementoenamel junction.[2] The condition results in unfavorable esthetics, a roller-coaster of soft- and hard-tissue anatomy, gingival clefts and fissures, loss of keratinized attached gingiva, increased root caries susceptibility and dentin hypersensitivity.[3,4] Trauma from toothbrushing, malposition of teeth, periodontal disease, and ectopic insertion of freni and muscle attachment are the main etiological factors for Miller Class I and Class II recession defects.[5] Increasing age, periodontal disease and smoking are environmental factors that negatively influence gingival health, and recession is frequently seen in these individuals.[1] The affliction of multiple adjacent teeth with recession have been termed Multiple Adjacent Recession Type Defects (MARTD)[6] or Multiple Recession Type Defects (MRTD) interchangeably in scientific literature.[5] Currently there are a multitude of perio-plastic surgical techniques for soft-tissue coverage of the exposed root surfaces in MRTDs. These include the coronally advanced flap (CAF), the modified CAF,[7] modified CAF with an subepithelial connective tissue graft (CAF+SCTG),[8,9] CAF with connective tissue graft (CAF+CTG),[9,10] CAF with orthodontic buttons,[6] expanded
The New York State Dental Journal AUGUST/SEPTEMBER 2021 23 ●
