Çoklu Diş Eti Çekilmelerinin Modifiye Tünel ve Modifiye VISTA Teknikleri ile Tedavisi: Bir Vaka Raporu

Abstract

Diş eti çekilmesi (DÇ), diş eti kenarının travma, inflamasyon veya çeşitli anatomik faktörler nedeniyle mine-sement sınırına göre apikale doğru yer değiştirmesidir. Böylece tek veya birden çok dişin labial veya lingual/palatinal kök yüzeylerinin açığa çıkmasına neden olur. Periodontolojinin uzun dönem hedeflerinin arasında da bu kök yüzeyleri kapatmak yer almaktadır. DÇ dentin hassasiyeti, kök çürükleri ve oral hijyenin idame ettirilememesine neden olabildiği gibi yarattığı estetik problemler, hastayı hekime getiren nedenlerin başında yer almaktadır. Protetik ve restoratif yöntemlerle tedavi edilebilmekle beraber kabul edilebilir biyolojik sonuçlara sahip oldukları için cerrahi yöntemler DÇ için tercih edilmektedir. Cerrahi yönteme bağ dokusu grefti (BDG) ilavesinin tam kök kapamada en iyi sonucu sağlayacağı bildirilmiştir. BDG’nin kullanıldığı koronale ve laterale pozisyone flepler, çift papil flebi, semilunar flep gibi flep tasarımlarının yanında son dönemlerde papiller bütünlüğe saygı duyacak şekilde çeşitli flep tasarımları önerilmiştir. Modifiye tünel ve modifiye vestibüler insizyon subperiostal tünel erişimi (VISTA) teknikleri bunlardan ikisidir. Bu vaka raporunda bağ doku grefti ile bu iki teknik kullanılarak, hassasiyet ve estetik şikayetlerle kliniğimize başvuran hastanın maksiller bölgedeki iki taraflı çoklu DÇ’in tedavisi ve 9 aylık takibi sunulmaktadır.

Keywords

• Diş eti çekilmesi
• bağ doku grefti
• mukogingival cerrahi

Treatment of Multiple Gingival Recessions with Modified Tunnel and Modified VISTA Techniques: A Case Report

Abstract

Gingival recession (GR) is the displacement to apical shift of the gingival margin respect to the enamel-cementum junction due to trauma, inflammation or various anatomical factors. Thus, it causes the labial or lingual/palatinal root surfaces of single or multiple teeth to be exposed. One of the long-term aims of periodontology is to cover these root surfaces. As GR may cause dentin sensitivity, root caries and failure to maintain oral hygiene, the aesthetic problems they create are among the main reasons that bring the patient to the physician. Although they can be treated with prosthetic and restorative methods, surgical methods are preferred for GR because they have acceptable biological results. It has been reported that the addition of the connective tissue graft (CTG) to surgical method will provide the best result to achieve complete root closure. In addition to flap designs such as coronally and laterally positioned flaps, double papillary flaps, semilunar flaps in which CTG is used, various flap designs have recently been proposed to respect papillary integrity. Modified tunnel and modified vestibular incision subperiosteal tunnel access (VISTA) techniques are two of them. In this case report, the treatment of bilateral multiple GR in the maxillary region of the patient who applied to our clinic with sensitivity and aesthetic complaints using these two techniques with CTG and 9-month follow-up is presented.

Keywords

• Gingival recession
• connective tissue graft
• mucogingival surgery

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