법랑기질유도체와 결합조직이식술을 이용한 치근피개술: 치은퇴축과 관련된 다양한 증례

Subepithelial connective tissue graft in combination with enamel matrix derivative for root coverage within different case of gingival recession: Case report

  • 이재홍 (원광대학교 대전치과병원)
  • Lee, Jae-Hong (Department of Periodontology, School of Dentistry, Wonkwang university)
  • 투고 : 2017.01.23
  • 심사 : 2017.02.02
  • 발행 : 2017.03.01

초록

Root coverage can be an efficacious treatment not only in aspect of dental symptoms like root caries and hypersensitivity, but also in aspect of esthetic problem. There are several predictable methods for gaining a connective tissue attachment to an exposed root surface. Among them, this case report will deal with three cases using enamel matrix derivative and connective tissue graft to recover esthetic and physiological periodontal environment and its form. This case report deals with three patients with gingival recession which has occurred by different causes. They were treated with de-epithelialized graft accompanied by application of enamel matrix derivative. 6-12 months later, all three patients showed considerable root coverage and clinically stable condition of healing. In conclusion, within the limitation of this study, de-epithelialized connective tissue graft accompanied by application of enamel matrix derivative shows stable and clinical acceptable results in aspect of root coverage.

키워드

참고문헌

  1. Loe H, Anerud A, Boysen H. The natural history of periodontal disease in man: prevalence, severity, and extent of gingival recession. J Periodontol 1992; 63:489-495. https://doi.org/10.1902/jop.1992.63.6.489
  2. Baker DL, Seymour GJ. The possible pathogenesis of gingival recession. A histological study of induced recession in the rat. J Clin Periodontol 1976; 3:208-219. https://doi.org/10.1111/j.1600-051X.1976.tb00040.x
  3. Miller PD, Jr. A classification of marginal tissue recession. Int J Periodontics Restorative Dent 1985; 5:8-13.
  4. Wennstrom JL, Zucchelli G. Increased gingival dimensions. A significant factor for successful outcome of root coverage procedures? A 2-year prospective clinical study. J Clin Periodontol 1996; 23:770-777. https://doi.org/10.1111/j.1600-051X.1996.tb00608.x
  5. Ricci G, Silvestri M, Tinti C, Rasperini G. A clinical/statistical comparison between the subpedicle connective tissue graft method and the guided tissue regeneration technique in root coverage. Int J Periodontics Restorative Dent 1996; 16:538-545.
  6. Nelson SW. The subpedicle connective tissue graft. A bilaminar reconstructive procedure for the coverage of denuded root surfaces. J Periodontol 1987; 58:95-102. https://doi.org/10.1902/jop.1987.58.2.95
  7. 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 Suppl 3:178-194; discussion 195-176. https://doi.org/10.1034/j.1600-051X.29.s3.11.x
  8. Heijl L. Periodontal regeneration with enamel matrix derivative in one human experimental defect. A case report. J Clin Periodontol 1997; 24:693-696. https://doi.org/10.1111/j.1600-051X.1997.tb00251.x
  9. McGuire MK, Cochran DL. Evaluation of human recession defects treated with coronally advanced flaps and either enamel matrix derivative or connective tissue. Part 2: Histological evaluation. J Periodontol 2003; 74:1126-1135. https://doi.org/10.1902/jop.2003.74.8.1126
  10. Zucchelli G, Clauser C, De Sanctis M, Calandriello M. Mucogingival versus guided tissue regeneration procedures in the treatment of deep recession type defects. J Periodontol 1998; 69:138-145. https://doi.org/10.1902/jop.1998.69.2.138
  11. Trombelli L, Scabbia A, Tatakis DN, Calura G. Subpedicle connective tissue graft versus guided tissue regeneration with bioabsorbable membrane in the treatment of human gingival recession defects. J Periodontol 1998; 69:1271-1277. https://doi.org/10.1902/jop.1998.69.11.1271
  12. Ricci G, Silvestri M, Rasperini G, Cattaneo V. Root coverage: a clinical/statistical comparison between subpedicle connective tissue graft and laterally positioned full thickness flaps. J Esthet Dent 1996; 8:66-73. https://doi.org/10.1111/j.1708-8240.1996.tb00887.x
  13. Zucchelli G, Mele M, Stefanini M, et al. Patient morbidity and root coverage outcome after subepithelial connective tissue and deepithelialized grafts: a comparative randomizedcontrolled clinical trial. J Clin Periodontol 2010; 37:728-738.
  14. Griffin TJ, Cheung WS, Zavras AI, Damoulis PD. Postoperative complications following gingival augmentation procedures. J Periodontol 2006; 77:2070-2079. https://doi.org/10.1902/jop.2006.050296
  15. Aroca S, Molnar B, Windisch P, et al. Treatment of multiple adjacent Miller class I and II gingival recessions with a Modified Coronally Advanced Tunnel (MCAT) technique and a collagen matrix or palatal connective tissue graft: a randomized, controlled clinical trial. J Clin Periodontol 2013; 40:713-720. https://doi.org/10.1111/jcpe.12112
  16. Roman A, Soanca A, Kasaj A, Stratul SI. Subepithelial connective tissue graft with or without enamel matrix derivative for the treatment of Miller class I and II gingival recessions: a controlled randomized clinical trial. J Periodontal Res 2013; 48:563-572. https://doi.org/10.1111/jre.12039
  17. Rasperini G, Roccuzzo M, Francetti L, et al. Subepithelial connective tissue graft for treatment of gingival recessions with and without enamel matrix derivative: a multicenter, randomized controlled clinical trial. Int J Periodontics Restorative Dent 2011; 31:133-139.
  18. Cortellini P, Pini Prato G. Coronally advanced flap and combination therapy for root coverage. Clinical strategies based on scientific evidence and clinical experience. Periodontol 2000 2012; 59:158-184. https://doi.org/10.1111/j.1600-0757.2011.00434.x
  19. Sato S, Yamada K, Kato T, et al. Treatment of Miller Class III recessions with enamel matrix derivative (Emdogain) in combination with subepithelial connective tissue grafting. Int J Periodontics Restorative Dent 2006; 26:71-77.
  20. Henriques PS, Pelegrine AA, Nogueira AA, Borghi MM. Application of subepithelial connective tissue graft with or without enamel matrix derivative for root coverage: a split-mouth randomized study. J Oral Sci 2010; 52:463-471. https://doi.org/10.2334/josnusd.52.463
  21. Velasquez-Plata D, Scheyer ET, Mellonig JT. Clinical comparison of an enamel matrix derivative used alone or in combination with a bovinederived xenograft for the treatment of periodontal osseous defects in humans. J Periodontol 2002; 73:433-440. https://doi.org/10.1902/jop.2002.73.4.433
  22. Zucchelli G, Amore C, Montebugnoli L, De Sanctis M. Enamel matrix proteins and bovine porous bone mineral in the treatment of intrabony defects: a comparative controlled clinical trial. J Periodontol 2003; 74:1725-1735. https://doi.org/10.1902/jop.2003.74.12.1725