Treatment Solution: Recession Coverage

WEBINAR

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WEBINAR

CLINICAL CASE

1 – Pre-operative lateral smile showing the recession defect of tooth 5.
2 – Pre-operative image of recession defect (tooth 5).
3 – After elevation of split-full-split flap the interdental papillae are de-epithelialized.
4 – Geistlich Mucograft® is placed over the root and sutured to the papillae
5 – The flap is mobilized, coronally advanced and sutured completely covering the Geistlich Mucograft®.
6 – Healing of the surgical site 2 weeks after surgery.
7 – Surgical site 6 months after surgery.
8 – Outcome 1 year after treatment.
9 – Lateral smile 1 year after surgery showing the optimal esthetic outcome.

CLINICAL CASE

1 – Before preparation of the flap the exposed root portion is cleaned with a scraper and is wiped with EDTA (or similar).
2 – After measuring the dimension of the recession defect using a periodontal probe, the incisions for raising the flap are cut.
3 – A split-full-split thickness flap is elevated and coronally mobilized.
4 – The area of the papillae is de-epithelialized to allow anchorage of the flap coronal to the cemento-enamel junction.
5 – Geistlich Mucograft®is applied dry to the defect and is fixed with 4 single sutures.
6 – The coronally advanced flap is sutured over Geistlich Mucograft®.
7 – Nice, uneventful healing 15 days post-operatively at suture removal.
8 – Soft tissue situation immediately after suture removal.
9 – Complete root coverage 7 months after surgery. Note the excellent color match.

CLINICAL CASE

1 – Pre-operative image showing the recession defect on tooth #6.
2 – After elevation of a partial thickness flap, the interdental papillae are de-epithelialized.
3 – Geistlich Mucograft® is placed over the defect and sutured to the papillae.
4 – The flap is coronally advanced and sutured completely covering the matrix.
5 – Follow-up after 1 week: healing of the surgical site.
6 – Follow-up situation after 4 weeks.
7 – Follow-up after 3 months.
8 – Follow-up after 6 months: note the natural appearance of the soft tissue achieved with Geistlich Mucograft®.
9 – Follow-up after 1 year.

CLINICAL CASE

1 – Pre-operative picture of the area intended to treat. Note the thin biotype.
2 – Initial situation showing Miller Class I defects on region 4 (3 mm) and 5 (2 mm).
3 – A split-full-split thickness flap without releasing incisions is elevated.
4 – The anatomical papillae are de epithelialized.
5 – The collagen matrix Geistlich Mucograft® is placed under the flap.
6 – Immediate post-operative situation after suturing of the flap covering Geistlich Mucograft® completely
7 – Follow-up picture 2 weeks after surgery.
8 – Nice healing of the site 1.5 months post-operative.
9 – Pleasant esthetic outcome 7 months after surgery.

CLINICAL CASE

1 – Baseline: multiple recession defect Miller Class I with keratinized tissue less than 3 mm on teeth #7 to #5.
2 – Coronally advanced flap preparation and elevation for sufficient release.
3 – Geistlich Fibro-Gide® is cut in half to 3 mm thickness.
4 – 3 mm Geistlich Fibro-Gide® is placed in the defect and absorbs blood immediately.
5 – Positioning of Geistlich Fibro-Gide® and fixation with single sutures (7-0 PGA sutures).
6 – Tension-free wound closure with sling sutures (6-0 PGA sutures).
7 – Suture removal 14 days post-surgery.
8 – Follow-up after 12 months: complete root coverage with Geistlich Fibro-Gide® is achieved.
9 – 2 year follow-up: complete root coverage with Geistlich Fibro-Gide®.

CLINICAL CASE

1 – Clinical presentation at baseline, with the patient exhibiting multiple gingival recessions associated with dental hypersensitivity.
2 – A coronally advanced flap was performed, with the interincisal papilla that was preserved.
3 – Xenogeneic cross-linked collagen matrix (Geistlich Fibro-Gide®).
4 – Application of the collagen matrix over the recipient site.
5 – Suturing of the collagen matrix to the de-epithelialized anatomical papillae using simple interrupted sutures (7/0 PGA).
6 – Stabilization of the two collagen matrices.
7 – The flap was coronally advanced and stabilized with sling sutures (7/0 polypropylene).
8 – Clinical outcomes at 6 months showing complete root coverage of the frontal teeth, and a significant reduction on the first premolars. The patient reported a substantial reduction of the preoperative dental hypersensitivity, together with high treatment satisfaction.

CLINICAL CASE

1 – Gingival recessions #23 and #22
3 – 10 week post op healing. Root coverage achieved. Patient reports no problems and is pleased with the results. More follow ups to come.
2 – Sites at the day of the procedure after sutures placed. Tunnel between #23,24 and partial thickness flap raised between #23,22.

CLINICAL CASE

1 – Baseline: recession defect Miller Class I on tooth #11.
2 – Trapezoidal flap design: split-full-split flap elevation flap.
3 – Positioning of Geistlich Fibro-Gide® and fixation with single sutures (PGA 7.0 Sutures) at the base of the de-epithelialized anatomic papillae and in the apical mesial and distal angles.
4 – Tension-free wound closure with two sling sutures (PGA 6.0 Sutures).
5 – Suture removal 14 days post-surgery.
6 – Buccal view 3 months post-surgery.
7 – Buccal view 6 months post-surgery.
8 – Follow-up after 1 year: complete root coverage with Geistlich Fibro-Gide® is achieved.
9 – 3 year post-surgery: stable results with Geistlich Fibro-Gide®.

CLINICAL CASE

1 – Baseline: recession defects on teeth #19 to #22 in the lower left quadrant. Exposed root surfaces of these teeth were thoroughly scaled and root planed before surgery.
2 – A full thickness muco-gingival tunnel was prepared through a minimally-invasive vestibular access incision apical to the teeth with gingival recessions.
3 – Geistlich Fibro-Gide® was cut into small pieces in a dry state using a scalpel.
4 – Insertion of Geistlich Fibro-Gide® into the subperiosteal tunnel.
5 – Geistlich Fibro-Gide® in situ: the gingival margin had been coronally advanced and stabilized after pieces of Geistlich Fibro-Gide® were placed.
6 – 1 week post-surgery: anchoring sutures were left in place for 1-2 weeks.
7 – 2 weeks post-surgery: anchoring sutures in place.
8 – 2 weeks post-surgery: removal of anchoring sutures.
9 – 7 months post-surgery: complete recession coverage.