Dentaltown January 2017 - 70
Fig. 10
Fig. 11
Options for treatment
There are myriad techniques and options
for treatment of gingival recession. For the
sake of brevity, let's pare it down to using
either the patient's own tissue or donor tissue.
When using the patient's own tissue, we're
able to harvest it intraorally, usually from
the palate's autogenous gingival tissue (free
gingival tissue) or autogenous connective
tissue (subepithelial connective tissue).
On occasion, a coronally positioned flap or
lateral pedicle flap can be employed to cover
a root as a sole treatment technique. These
techniques are also used in combination
with subepithelial connective tissue grafts.
The original procedure to treat mucogingival defects was the free-gingival graft.
Th is technique, still used today, provides
a predictable way to create a thick band of
keratinized gingiva. The gingival tissue is
typically harvested from the hard palate
and is sutured over the area where the void
in keratinized gingiva exists. The advantage
of this technique is that it predictably
establishes a zone of keratinized tissue
and has long-term stability. The main
disadvantage is that it's a quite painful
recovery for the patient and often does not
70
JANUARY 2017 // dentaltown.com
Fig. 12
create an aesthetic, blended appearance.
Also, root coverage is not an intended
outcome, so if aesthetics and root coverage
are desired goals, this isn't the best technique
to accomplish that.
Several years after the free-gingival graft
was first described by Bjorn, the subepithelial
connective tissue graft was created. Instead
of harvesting the outer epithelial of tissue
like the free-gingival graft, the subepithelial
connective tissue is harvested from the layer of
tissue just under the epithelial. (See why it is
called a subepithelial connective tissue graft?)
The outcome of this technique for the patient
is a much less painful recovery. Clinically,
this technique yields a better color match
and root coverage. The main disadvantage
is that a broad zone of keratinized gingiva
isn't created; however, it's debatable as to
whether it's necessary to have keratinized
gingiva around teeth to prevent further
breakdown.
Let's look at the differences as to where
and how we harvest the tissue, and how
these typically look postsurgically. Fig. 10
shows a free-gingival graft incision, while
Fig. 11 shows a subepithelial connective
tissue graft incision.
http://www.dentaltown.com
Table of Contents for the Digital Edition of Dentaltown January 2017
CE Update
On Dentaltown.com
Study Abroad: Live CE Events
Industry News
New Products
Poll
Product Profile: Glidewell Laboratories
Ad Index
Product Profile: OCO Biomedical
The Curious History of Occlusion in Dentistry
Making a Good First Impression
Townie Meeting 2017 Preview
Howard Speaks: Suck It Up Buttercup
Professional Courtesy: Package Deal
Show Your Work: Crowning a Winner
Product Profile: Aspen Dental
Dentally Incorrect
Message Boards: Best Way to Text Patients
Message Boards: Teach An Old Guy About Perio
Message Boards: Powerprox 6-Month Braces (Trouble Getting Started)
Office Visit
Does My Patient Need A Gum Graft
Earn Your Keepers
CE Requirements by State
CE: Honing Our Edge
Dentaltown January 2017 - Intro
Dentaltown January 2017 - Cover1
Dentaltown January 2017 - Cover2
Dentaltown January 2017 - 1
Dentaltown January 2017 - 2
Dentaltown January 2017 - 3
Dentaltown January 2017 - 4
Dentaltown January 2017 - 5
Dentaltown January 2017 - 6
Dentaltown January 2017 - 7
Dentaltown January 2017 - 8
Dentaltown January 2017 - 9
Dentaltown January 2017 - On Dentaltown.com
Dentaltown January 2017 - 11
Dentaltown January 2017 - Howard Speaks: Suck It Up Buttercup
Dentaltown January 2017 - 13
Dentaltown January 2017 - 14
Dentaltown January 2017 - 15
Dentaltown January 2017 - Professional Courtesy: Package Deal
Dentaltown January 2017 - 17
Dentaltown January 2017 - CE Update
Dentaltown January 2017 - 19
Dentaltown January 2017 - 20
Dentaltown January 2017 - 21
Dentaltown January 2017 - Study Abroad: Live CE Events
Dentaltown January 2017 - 23
Dentaltown January 2017 - Industry News
Dentaltown January 2017 - New Products
Dentaltown January 2017 - Poll
Dentaltown January 2017 - 27
Dentaltown January 2017 - Show Your Work: Crowning a Winner
Dentaltown January 2017 - 29
Dentaltown January 2017 - 30
Dentaltown January 2017 - 31
Dentaltown January 2017 - Message Boards: Best Way to Text Patients
Dentaltown January 2017 - 33
Dentaltown January 2017 - 34
Dentaltown January 2017 - 35
Dentaltown January 2017 - 36
Dentaltown January 2017 - 37
Dentaltown January 2017 - Message Boards: Teach An Old Guy About Perio
Dentaltown January 2017 - 39
Dentaltown January 2017 - 40
Dentaltown January 2017 - 41
Dentaltown January 2017 - 42
Dentaltown January 2017 - Message Boards: Powerprox 6-Month Braces (Trouble Getting Started)
Dentaltown January 2017 - 44
Dentaltown January 2017 - 45
Dentaltown January 2017 - 46
Dentaltown January 2017 - 47
Dentaltown January 2017 - Office Visit
Dentaltown January 2017 - 49
Dentaltown January 2017 - 50
Dentaltown January 2017 - 51
Dentaltown January 2017 - 52
Dentaltown January 2017 - 53
Dentaltown January 2017 - The Curious History of Occlusion in Dentistry
Dentaltown January 2017 - 55
Dentaltown January 2017 - 56
Dentaltown January 2017 - 57
Dentaltown January 2017 - 58
Dentaltown January 2017 - 59
Dentaltown January 2017 - 60
Dentaltown January 2017 - 61
Dentaltown January 2017 - 62
Dentaltown January 2017 - Making a Good First Impression
Dentaltown January 2017 - 64
Dentaltown January 2017 - 65
Dentaltown January 2017 - Does My Patient Need A Gum Graft
Dentaltown January 2017 - 67
Dentaltown January 2017 - 68
Dentaltown January 2017 - 69
Dentaltown January 2017 - 70
Dentaltown January 2017 - 71
Dentaltown January 2017 - Earn Your Keepers
Dentaltown January 2017 - 73
Dentaltown January 2017 - 74
Dentaltown January 2017 - 75
Dentaltown January 2017 - Townie Meeting 2017 Preview
Dentaltown January 2017 - 77
Dentaltown January 2017 - 78
Dentaltown January 2017 - 79
Dentaltown January 2017 - 80
Dentaltown January 2017 - 81
Dentaltown January 2017 - 82
Dentaltown January 2017 - 83
Dentaltown January 2017 - 84
Dentaltown January 2017 - 85
Dentaltown January 2017 - 86
Dentaltown January 2017 - 87
Dentaltown January 2017 - Product Profile: Glidewell Laboratories
Dentaltown January 2017 - Ad Index
Dentaltown January 2017 - Product Profile: OCO Biomedical
Dentaltown January 2017 - 91
Dentaltown January 2017 - Product Profile: Aspen Dental
Dentaltown January 2017 - 93
Dentaltown January 2017 - CE Requirements by State
Dentaltown January 2017 - 95
Dentaltown January 2017 - CE: Honing Our Edge
Dentaltown January 2017 - 97
Dentaltown January 2017 - 98
Dentaltown January 2017 - 99
Dentaltown January 2017 - 100
Dentaltown January 2017 - 101
Dentaltown January 2017 - 102
Dentaltown January 2017 - Dentally Incorrect
Dentaltown January 2017 - 104
Dentaltown January 2017 - Cover3
Dentaltown January 2017 - Cover4
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