            TY  - JOUR
T1  - Diş Eti Çekilmesi Tedavisinde Tünel Tekniği ile Birlikte Çift Çapraz Sütur Uygulaması: Olgu Serisi
TT  - Application of Double Cross Suture with Tunnel Technique in the Treatment of Gingival Recession: Case Series
AU  - Önder, Yasemin Beliz
PY  - 2023
DA  - August
JF  - Van Diş Hekimliği Dergisi
JO  - VDJ
PB  - Van Yüzüncü Yıl Üniversitesi
WT  - DergiPark
SN  - 2757-6868
SP  - 52
EP  - 57
VL  - 4
IS  - 1
LA  - tr
AB  - Diş eti çekilmesi (DÇ) tedavi edilirken birçoktekniğin başarısından söz etmek mümkündür. Butekniklerden özellikle minimal invaziv bir teknikolan tünel tekniği, post-operatif olarak daha ağrısız,morbiditesi daha az ve başarılı bir tekniktir. Bununlabirlikte tünel operasyonu sırasında kök yüzeyikapanmasının sağlanabilmesi için serbestleştirilenflep koronale yer değiştirmelidir. Bu noktada süturtekniği de son derece önemlidir. Özellikle hemgreftin stabilizasyonunu sağlamak hem de flebikoronale ilerletmek için çift-çapraz sütur tekniğibaşarılı bir yöntemdir. Bu olgu serisinin amacı; tüneloperasyonları sırasında çift-çapraz sütur tekniğiuygulanmasının kısa dönem etkinliğininaraştırılmasıdır. Cairo DÇ tip 1 ve 2 DÇ’ye sahipsistemik olarak sağlıklı üç hastada tünel tekniğiuygulanırken palatinal sahadan de-epitelize serbestdiş eti grefti elde edilmiş ve serbestleştirilen flepiçerisine yerleştirilmiştir. Yerleştirilen greft çiftçaprazsütur tekniği ile hem flebe sabitlenmiş hem dekoronale ilerletilmiştir. Hastalar iki ay takipedilmiştir. Bu vaka serisinde DÇ’lerin tedavisindepost-operatif ağrı minimal düzeyde olmuştur.Uygulanan teknik ile hastaların estetik beklentilerikarşılanmıştır. Bu sütur tekniği ile papilbütünlüğünün bozulmadığı görülmüş ve dokununbeslenmesi sırasında erken dönemde birkomplikasyonla karşılaşılmamıştır. Bu vaka sersininsonuçları dahilinde çift-çapraz sütur tekniğiyleuygulanan tünel operasyonu ile DÇ tedavisindeetkili sonuçlar verdiği söylenebilir.
KW  - Bağ dokusu grefti
KW  - diş eti
çekilmesi
KW  - sütur tekniği
N2  - It’s possible to talk about the success ofmany techniques when treating gingival recession(GR). The tunnel technique, which is a minimallyinvasive technique, is a more painless, less morbidand successful post-operative technique. However,the released flap must be coronally displaced toensure root surface closure during tunnel operation.At this point, the suture technique is also extremelyimportant. In particular, the double-cross suturetechnique (DCST) is a successful method for bothstabilizing the graft and advancing the flapcoronally. The aim of this case series is; the aim of thisstudy is to investigate the short-term effectiveness ofapplying the DCST during tunnel operations. Whileperforming the tunnel technique in threesystemically healthy patients with Cairo type 1-2 GR,a de-epithelialized free gingival graft was obtainedfrom the palatal area and placed in the liberated flap.The implanted graft was both fixed to the flap andadvanced coronally with the DCST. The patientswere followed for two months. Post-operative painwas minimal in the treatment of GR in this caseseries. The aesthetic expectations of the patients weremet with the applied technique. With this suturetechnique, it’s observed that the integrity of thepapilla wasn’t impaired and no early complicationswere encountered during the feeding of the tissue.Within the results of this case series, it can be saidthat the tunnel operation applied with the DCSTgives effective results in the treatment of GR.
CR  - 1. Zucchelli G, Mounssif I. Periodontal plastic
surgery. Periodontol 2000 2015;68(1):333–68.
CR  - 2. Chambrone L, Tatakis DN. Periodontal soft
tissue root coverage procedures: a systematic
review from the AAP Regeneration Workshop.
J Periodontol. 2015;86(2):8–51.
CR  - 3. Francetti L, Weinstein R, Taschieri S,
Corbella S. Coronally Advanced Flap With or
Without Subepithelial Connective Tissue Graft
for the Treatment of Single Recession: 5-Year
Outcomes from a Comparative Study. Int J
Periodontics Restorative Dent.
2018;38(6):819–25.
CR  - 4. Xue F, Zhang R, Zhang Y, Liu J, Cai Y, Cao
P, et al. Treatment of multiple gingival
recessions with concentrated growth factor
membrane and coronally advanced tunnel
technique via digital measurements: A
randomized controlled clinical trial. J Dent Sci.
2022;17(2):725.
CR  - 5. Rasperini G, Codari M, Limiroli E, Acunzo
R, Tavelli L, Levickiene A. Graftless Tunnel
Technique for the Treatment of Multiple
Gingival Recessions in Sites with Thick or Thick Biotype: A Prospective Case Series. Int J
Periodontics Restorative Dent. 2019
;39(6):203–10.
CR  - 6. Elangovan S. Tunneling Technique in
Conjunction With Autogenous Graft or Graft
Substitutes Is a Predictable Surgical Approach
to Achieve Root Coverage in Isolated or
Multiple Gingival Recession Defects. J Evid
Based Dent Pract. 2019;19(2):189–91.
CR  - 7. Santamaria MP, Neves FL da S, Silveira CA,
Mathias IF, Fernandes-Dias SB, Jardini MAN,
et al. Connective tissue graft and tunnel or
trapezoidal flap for the treatment of single
maxillary gingival recessions: a randomized
clinical trial. J Clin Periodontol.
2017;44(5):540–7.
CR  - 8. Zuhr O, Rebele SF, Cheung SL, Hürzeler
MB. Surgery without papilla incision: tunneling
flap procedures in plastic periodontal and
implant surgery. Periodontol 2000.
2018;77(1):123–49.
CR  - 9. Yadav V, Singh N, Bhatia A, Kamra P,
Yadav R. A Modified Suturing Protocol for
Tripod Stabilization of Connective Tissue Graft
and Coronal Advancement of Tunnel Flap for
Treatment of Isolated Gingival Recession. Int J
Periodontics Restorative Dent. 2022;42(1):9–
14.
CR  - 10. Cairo F, Nieri M, Cincinelli S, Mervelt J,
Pagliaro U. The interproximal clinical
attachment level to classify gingival recessions
and predict root coverage outcomes: an
explorative and reliability study. J ClinPeriodontol. 2011;38(7):661–6.
CR  - 11. Baker P. Gingival Recession - Causes and
Management. Prim Dent J. 2020;8(4):40–7.
CR  - 12. Sullivan HC, Atkins JH. Free autogenous
gingival grafts. I. Principles of successful
grafting. Periodontics 1968;6(3):121–9.
CR  - 13. Miller PD. A classification of marginal
tissue recession. Int J Periodontics Restorative
Dent. 1985;5(2):8–13.
CR  - 14. Chapple ILC, Mealey BL, Van Dyke TE,
Bartold PM, Dommisch H, Eickholz P, et al.
Periodontal health and gingival diseases and
conditions on an intact and a reduced
periodontium: Consensus report of workgroup
1 of the 2017 World Workshop on the
Classification of Periodontal and Peri-Implant
Diseases and Conditions. J Periodontol.
2018;89:74–84.
CR  - 15. McLeod DE, Reyes E, Branch-Mays G.
Treatment of multiple areas of gingival
recession using a simple harvesting technique
for autogenous connective tissue graft. J
Periodontol. 2009;80(10):1680–7.
CR  - 16. Tavelli L, Barootchi S, Nguyen TVN,
Tattan M, Ravidà A, Wang HL. Efficacy of
tunnel technique in the treatment of localized
and multiple gingival recessions: A systematic
review and meta-analysis. J Periodontol.
2018;89(9):1075–90.
UR  - https://dergipark.org.tr/tr/pub/vdj/article/1338607
L1  - https://dergipark.org.tr/tr/download/article-file/3311883
ER  -