Background information
Dr. Daniele Cardaropoli:
Gingival recession is defined as the displacement of the marginal tissue apical to the cementoe amel junction with exposure of the root surface1,2. Problems commonly associated with the
n
presence of gingival recessions are compromised aesthetics, root hypersensitivity, higher incidence of root caries, and compromised plaque control.
Treatment of gingival recession is performed via mucogingival therapy, which includes surgical
and nonsurgical procedures (periodontal plastic surgery, oral hygiene, orthodontic therapy) for
correction of soft-tissue defects3-5. The treatment of buccal soft-tissue defects is mainly concerned
with reshaping of the gingival architecture, and in some cases concomitant efforts to increase the
amount of keratinised tissue is indicated6-11. Thus, the rationale for treating gingival recessions is
r
elated to aesthetics and root hypersensitivity.
Fig. 5 Both mesial and distal papillae are de-epithelialised in order to secure anchorage of the flap onto
a connective bed. The root surface is scaled and
planed with ultrasonic, rotary burs and hand instruments to produce a decontaminated, smooth and
flattened surface.
Fig. 6 The Geistlich Mucograft® collagen matrix is
trimmed to conform to the surgical field in a dry state.
Fig. 7 The trimmed Geistlich Mucograft® collagen
matrix is presutured with a single-loop sling suture.
Fig. 8 The collagen matrix is fixed with a single-loop
sling suture around the cemento-enamel junction,
and two single sutures at the mesial and distal sides
of the flap.
Fig. 9 The pedicle flap is positioned to the cementoenamel junction by means of a double-loop sling
suture, and the releasing incisions are sutured to
complete primary closure of the area.
Fig. 10 Primary closure maintained after 2 weeks, on
the day of suture removal. No signs of inflammation
are present.
Patient: Male, 59 years old, referred to the practice for gingival and orthodontic therapy.
Fig. 4 A combined (from coronal to apical) splitthickness, full-thickness and split-thickness flap
is elevated. Split-thickness mesially and distally
to the root surface, full-thickness apical to the
recession and