LOKALİZE DİŞETİ ÇEKİLMELERİN TEDAVİSİNDE PALATAL GREFT İLE GİNGİVAL ÜNİTENİN KARŞILAŞTIRILMASI

Yıl 2024, Cilt: 13 Sayı: 1, 10 - 18, 26.01.2024

Dilek Özkan Şen , Fatma Ucan Yarkac , Elif Öncü

https://doi.org/10.54617/adoklinikbilimler.1129401

Öz

Amaç:Bu çalışmanın amacı lokalize dişeti çekilmesi bulunan hastalarda serbest dişeti greftinde gingival ünite ve geleneksel yöntemin objektif ve subjektif estetik sonuçlarını ve başarısını değerlendirmektir.
Gereç ve Yöntem:Miller I-II çekilme defekti olan 26 hasta dahil edildi.Dişeti çekilmeleri serbest dişeti grefti operasyonu ile tedavi edildi ve iki gruba ayrıldı: Grup 1;palatal greft ile (n=12), Grup 2;gingival ünite grefti ile tedavi edilen bireyler (n=14).Dişeti çekilmesi, keratinize doku genişliği, klinik ataşman seviyesi, plak indeksi, gingival indeks, cep derinliği gibi klinik periodontal parametreler başlangıçta ve 6 ay sonra ölçüldü.Hastaların memnuniyet ve hastaların ve hekimlerinin estetik algı puanları başlangıçta ve 6 ay sonra kaydedildi.
Bulgular:Başlangıçta dişeti çekilme derinliği grup 2'de grup 1'e göre daha yüksekti.Tedavi sonrası tüm gruplarda dişeti çekilme derinliğinde azalma ve keratinize doku genişliğinde artış görüldü (p<0.05).Tedavi sonrası her iki grupta da hastaların memnuniyet algısı arttı.Toplam hasta memnuniyeti skorları karşılaştırıldığında, başlangıçta gruplar arasında anlamlı bir fark bulunmadı.Ayrıca tedavi sonrası hasta ve hekimlerin estetik algı puanları grup 2'de grup 1'e göre daha yüksekti(p <0.05).
Sonuç:Bu çalışmada, her iki yöntemin de çekilme derinliğini azalttığı, keratinize doku miktarını ve hastaların memnuniyet algılarını artırdığı görüldü.

Anahtar Kelimeler

DİŞETİ ÇEKİLMESİ, TRANSPLANTASYON, PERİODONTAL PLASTİK CERRAHİ

Comparison of Different Treatments in Gingival Recessions

Öz

Aim:The aim of this study is to evaluate the objective and subjective aesthetic results and success of the gingival unit and traditional method in free gingival graft in patients with localized gingival recession.
Material method:26 patients with Miller I-II defect were included.The individuals were treated and divided into two groups:Group1; with palatal graft(n=12),Group2;individuals treated with gingival unit grafts(n=14).Clinical parameters such as gingival recession, keratinized tissue,, clinical attachment level, plaque index, gingival index, pocket depth were measured at baseline and 6 months after surgery.Patients' perception of satisfaction and aesthetic scores of patients and dentists were evaluated at baseline and 6 months.
Results:At baseline, the depth of recession was higher in group2 than in group1.After treatment, a decrease in recession and an increase in keratinized tissue were observed in all groups.After the treatment, the satisfaction of the patients increased in both groups.When patient satisfaction scores were compared, there was no significant difference between the groups at baseline.Aesthetic scores of patients and dentists after treatment were higher in group2 than in group1.
Conclusion:In this study, it was observed that both methods decreased the depth of retraction, increased the amount of keratinized tissue and satisfaction of the patients.

Anahtar Kelimeler

gingival recession, periodontal plastic surgery, transplantation

Kaynakça

• Referans1. Miller PD Jr. A classification of marginal tissue recession. Int J Periodont Rest Dent 1985;5:8-13.
• Referans2. Periodontology A. Glossary of periodontal terms. Chicago (IL): Clin Adv Periodontics 2001.
• Referans3. Rees J, Addy M. A cross‐sectional study of dentine hypersensitivity. J Clin Periodontol 2002;29:997-1003.
• Referans4. Oliver RC, Brown LJ, Löe H. Periodontal diseases in the United States population. J Periodontol 1998;69:269-78.
• Referans5. Holbrook T, Ochsenbein C. Complete coverage of the denuded root surface with a one-stage gingival graft. Int J Periodontics Restorative Dent 1983;3:8-27.
• Referans6. Pfeifer JS, Heller R. Histologic evaluation of full and partial thickness lateral repositioned flaps: A pilot study. J Periodontol 1971;42:331-3.
• Referans7. Langer B, Langer L. Subepithelial connective tissue graft technique for root coverage. J Periodontol 1985;56:715-20.
• Referans8. Allen EP, Miller Jr PD. Coronal positioning of existing gingiva: short term results in the treatment of shallow marginal tissue recession. J Periodontol 1989;60:316-9.
• Referans9. Prato GP, Clauser C, Magnani C, Cortellini P. Resorbable Membrane in the Treatment of Human Buccal Recession: A Nine- Case Report. Int J Periodontics Restorative Dent 1995;15:258-67.
• Referans10. Roccuzzo M, Bunino M, Needleman I, Sanz M. Periodontal plastic surgery for treatment of localized gingival recessions: a systematic review. J Clin Periodontol 2002;29:178-94.
• Referans11. Chambrone L, Sukekava F, Araujo MG, Pustiglioni FE, Chambrone LA, Lima LA. Root coverage procedures for the treatment of localised recession‐type defects. Cochrane systematic review. J Periodontol. 2010;81:452-78.
• Referans12. Cairo F, Pagliaro U, Nieri M. Treatment of gingival recession with coronally advanced flap procedures: a systematic review. J Clin Periodontol 2008;35:136-62.
• Referans13. Jenabian N, Bahabadi MY, Bijani A, Rad MR. Gingival unit graft versus free gingival graft for treatment of gingival recession: a randomized controlled clinical trial. J Dent (Tehran, Iran) 2016;13:184-92.
• Referans14. Kindlova M, Matena V. Blood vessels of the rat molar. J Dent Res 1962;41:650-60.
• Referans15. Scardina G, Messina P. Morphologic changes in the microcirculation induced by chronic smoking habit: a videocapillaroscopic study on the human gingival mucosa. Am J Dent 2005;18:301-4.
• Referans16. Bergström J. Vascular reaction in plaque‐induced gingivitis: A quantitative approach. J Periodontal Res 1992;27:604-8.
• Referans17. Persson L, Bergström J. Smoking and vascular density of healthy marginal gingiva. Eur J Oral Sci 998;106:953-7.
• Referans18. Kuru B, Yıldırım S. Treatment of localized gingival recessions using gingival unit grafts: a randomized controlled clinical trial. J Periodontol 2013;84:41-50.
• Referans19. 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 Clin Periodontol 2011;38:661-6.
• Referans20. Cairo F, Rotundo R, Miller Jr PD, Pini Prato GP. Root coverage esthetic score: a system to evaluate the esthetic outcome of the treatment of gingival recession through evaluation of clinical cases. J Periodontol 2009;80:705-10.
• Referans21. Sağlam M, Köseoğlu S. Treatment of localized gingival recessions with free gingival graft. European J Gen Dent 2012;1:10-4.
• Referans22. Camargo PM, Melnick PR, Kenney EB. The use of free gingivalgrafts for aesthetic purposes. Periodontol 2000 2001;27:72-96.
• Referans23. Zucchelli G, Tavelli L, McGuire MK, Rasperini G, Feinberg SE, Wang HL, et al. Autogenous soft tissue grafting for periodontal and peri‐implant plastic surgical reconstruction. J Periodontol 2020;91:9-16.
• Referans24. Burkhardt R, Lang NP. Coverage of localized gingival recessions: comparison of micro‐and macrosurgical techniques. J Clin Periodontol 2005;32:287-93.
• Referans25. Shah R, Thomas R, Mehta DS. Recent modifications of free gingival graft: A case series. Contemp Clin Dent 2015;6:425-7.
• Referans26. Allen AL, Cohen DW. King and Pennel’s free graft series: a defining moment revisited. Compend Contin Educ Dent 2003;24:698-700, 702, 704-6.
• Referans27. Yıldırım S, Kuru B. Gingival unit transfer using in the Miller III recession defect treatment. World J Clin Cases 2015;3:199-203.
• Referans28. Tartous S. Comparison of free gingival graft and gingival unit graft for treatment of gingival recession: a randomized controlled trial. Int J Periodontics Restorative Dent 2020;40:e103-e10.
• Referans29. Kayaalti-Yüksek S, Yaprak E. The comparison of the efficacy of gingival unit graft with connective tissue graft in recession defect coverage: a randomized split-mouth clinical trial. Clin Oral Investig 2022;26:2761-70.