tetracycline and Gingival-Pocket

It was the aim of this study to compare barrier membrane therapy with connective tissue grafts in the treatment of recession defects. Fifteen patients with 2 paired vestibular recession defects participated in the study. After thorough scaling and root surface conditioning with tetracycline-HCl, defects were randomly assigned to 1 of 2 treatment modalities. In one of the defects, a trapezoidal mucoperiosteal flap was prepared, and a titanium reinforced expanded polytetrafluoroethylene membrane was adapted to the defect and secured by a sling suture. The membrane was subsequently covered by a coronally positioned flap secured with crown attached sutures. The other defect was treated with a connective tissue graft employing the "envelope technique." Twelve months after therapy, both treatment modalities showed significant root coverage and probing attachment gain. Gingival recession decreased from 3.6+/-0.7 mm to 0.5+/-0.5 mm for membrane treated defects and from 3.6+/-1.0 mm to 0.5+/-0.5 mm following use of grafts, corresponding to mean root coverages of 87.1% and 86.9%, respectively. Mean gains of keratinized tissue of 1.5 mm (membrane) and 2.5 mm (graft) could be observed. Thus, the results of this study demonstrate that both titanium reinforced barrier membranes and connective tissue grafts can be successfully used to treat periodontal recession defects.

Topics: Adult; Anti-Bacterial Agents; Connective Tissue; Dental Scaling; Female; Follow-Up Studies; Gingiva; Gingival Pocket; Gingival Recession; Guided Tissue Regeneration, Periodontal; Humans; Male; Membranes, Artificial; Middle Aged; Patient Satisfaction; Polytetrafluoroethylene; Surgical Flaps; Suture Techniques; Tetracycline; Titanium; Tooth Root

Thirty Class I and Class II recessions in 30 patients were treated with a modified subepithelial connective tissue graft procedure. Fifteen recessions in the test group received a tetracycline hydrochloride (50 mg/ml) root treatment for 5 minutes (TTC-HCl group); the remaining 15 recessions composed the control group and received a citric acid root treatment for 3 minutes (CA group). Clinical assessments were taken at baseline and at 6 months. The differences between treatments were not statistically significant. In the central area of the recession, the mean percentage of root coverage was 81.7% corresponding to a mean percentage of 79.3% and 84.0% for the TTC-HCl and the CA group, respectively. In the test group, 6 of the 15 recessions exhibited complete root coverage; the gingival augmentation was 57.8%. In the control group, 8 of the 15 recessions exhibited complete root coverage; the gingival augmentation was 43.6%. The mean surface area of root exposure was reduced from 11.53 mm2 and 13.30 mm2 to 0.34 mm2 and 0.29 mm2 for the TTC-HCl group and the CA group, respectively. This reduction corresponds to a mean percentage of 97.4% root coverage for both groups. Within the limits of this study, the results indicate that tetracycline hydrochloride and citric acid root conditioning have comparable clinical effects in root coverage surgical therapy. The data also suggest that the measurement of the surface area of the recession is a more accurate criterion in the evaluation of the mean percentage of root coverage than a single central vertical linear measurement.

Topics: Administration, Topical; Adult; Aged; Anti-Bacterial Agents; Citric Acid; Combined Modality Therapy; Connective Tissue; Female; Gingiva; Gingival Pocket; Gingival Recession; Humans; Male; Middle Aged; Surgical Flaps; Tetracycline; Tooth Root

A split-mouth clinical study was designed to determine the effect of fibrin glue (FG) in addition to tetracycline HCI (TTC) root conditioning and the coronally positioned flap (CPF) procedure in the treatment of maxillary buccal recession defects. 11 patients presenting with a pair of Class I or II recession defects were selected. After initial therapy, defect-specific and full-mouth oral hygiene standards and gingival condition, recession depth, recession width, probing depth, attachment level, and width of keratinized gingiva were recorded. The surgical procedure included elevation of a full split thickness flap, root debridement and root conditioning with a 10 mg/ml TTC solution for 4 minutes. According to a randomization list, in each patient, 1 defect was treated with topical FG application, while the paired defect did not receive FG. The flap was adapted and sutured coronally to the cemento-enamel junction without tension. Healing was evaluated 6 months postsurgery. Significant recession depth reduction and attachment gain were observed for both treatments. Average root coverage amounted to 65% in FG treated defects and 55% in defects treated with TTC conditioning only. There were no clinical and statistical significant differences between the treatments for any parameter considered. This study suggests that FG may not meaningfully enhance the outcome of the CPF procedure with TTC root conditioning.

Topics: Administration, Topical; Adult; Anti-Bacterial Agents; Combined Modality Therapy; Female; Fibrin Tissue Adhesive; Gingival Pocket; Gingival Recession; Humans; Male; Maxilla; Middle Aged; Oral Hygiene; Periodontal Attachment Loss; Root Planing; Surgical Flaps; Tetracycline; Tissue Adhesives; Tooth Root; Treatment Outcome; Wound Healing

The goal of this study was to evaluate the long-term stability of the root coverage results obtained with an acellular dermal matrix. The mean root coverage at 12 weeks postoperative was 91.7%. The mean root coverage at the final postoperative evaluation (mean 18.6 months) was 87.0%. This difference was not statistically or clinically significant. The root coverage results obtained with an acellular dermal matrix were predictable, esthetic, and stable over time.

Topics: Adult; Aged; Anti-Bacterial Agents; Biocompatible Materials; Collagen; Esthetics, Dental; Female; Follow-Up Studies; Gingiva; Gingival Pocket; Gingival Recession; Humans; Longitudinal Studies; Male; Middle Aged; Periodontal Attachment Loss; Root Planing; Statistics as Topic; Surgical Flaps; Tetracycline; Tooth Root

The present case report evaluates the treatment outcome following mucogingival surgery combined with a bioresorbable barrier in gingival recession defects in humans. A total of 11 buccal, Miller Class I or II, gingival recession defects in 6 patients were consecutively treated. The 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 and surrounding bone margins. A flap was 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 keratinized tissue width (KT). Immediately postsurgery, and at weeks 1, 2, 4, 6 and 8 postsurgery, the location of gingival margin or granulation tissue covering the previously exposed root surface was recorded, as well 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 months 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 gingival recession defects may be achieved by means of a barrier-supported envelope technique. The bioresorbable matrix barrier represented an effective scaffold to support the reconstruction of the mucogingival unit.

Topics: Adult; Alveolar Process; Analysis of Variance; Anti-Bacterial Agents; Biodegradation, Environmental; Dental Plaque Index; Dental Scaling; Epithelial Attachment; Evaluation Studies as Topic; Female; Follow-Up Studies; Gingiva; Gingival Pocket; Gingival Recession; Granulation Tissue; Humans; Male; Membranes, Artificial; Middle Aged; Periodontal Index; Surgical Flaps; Tetracycline; Tooth Cervix; Tooth Root; Treatment Outcome; Ultrasonic Therapy

The occurrence of creeping attachment has been documented with epithelialized autogenous masticatory mucosa grafts (free gingival grafts) and suggested in other root coverage techniques. The purpose of this study was to examine whether or not creeping attachment occurred after a connective tissue with partial-thickness double pedicle graft had been performed. This study examined 22 defects, in 19 patients, treated where less than complete root coverage was obtained at 4 weeks postoperative. Creeping attachment occurred in 21 of the 22 defects (95.5%), in 18 of the 19 patients (94.7%). Complete root coverage occurred in 17 of the 22 defects (77.3%), in 15 of 19 patients (78.9%). The mean creeping attachment obtained was 0.8 mm. Additionally, it was the goal of this study to see if any factor could be associated with creeping attachment. This study did not find any factors that could be associated with the amount of creeping attachment seen. Creeping attachment seems to occur commonly, but complete root coverage is not predictable.

Topics: Adult; Age Factors; Anti-Bacterial Agents; Bucrylate; Connective Tissue; Dental Plaque; Dentin Sensitivity; Epithelial Attachment; Female; Follow-Up Studies; Forecasting; Gingiva; Gingival Pocket; Gingival Recession; Humans; Keratins; Labial Frenum; Male; Periodontal Dressings; Root Planing; Smoking; Surgical Flaps; Tetracycline; Tissue Adhesives; Tooth Cervix; Tooth Root; Transplantation, Autologous; Wound Healing

Topics: Adolescent; Adult; Age Factors; Bone Resorption; Gingival Pocket; Humans; Mouth; Nutrition Disorders; Periodontal Splints; Periodontitis; Tetracycline; Tooth Exfoliation

Topics: Adult; Bacteria; Bacteroides; Dental Plaque; Female; Fusobacterium; Gingiva; Gingival Pocket; Gram-Negative Anaerobic Bacteria; Humans; Peptostreptococcus; Periodontal Diseases; Periodontal Index; Spirochaetales; Tetracycline; Time Factors