Document Detail

Coronally advanced flap and combination therapy for root coverage. Clinical strategies based on scientific evidence and clinical experience.
MedLine Citation:
PMID:  22507065     Owner:  NLM     Status:  In-Data-Review    
During the past three decades, several surgical techniques have been proposed to treat single and multiple gingival recessions. Evidence indicates that coronally advanced flap-based approaches result in the best clinical results. Among all the different techniques, the use of a graft under a coronally advanced flap results in the best short- and long-term outcomes in terms of root coverage and gain in keratinized tissue. The use of a coronally advanced flap + connective tissue graft would appear to be the best choice for root coverage. However, harvesting a graft from the palate adds morbidity, surgical chair-time and requires increased surgical skills. A potential alternative could be the use of enamel matrix derivatives under a coronally advanced flap, and this achieves similar clinical outcomes and is less invasive, but adds economic costs to the treatment. Evidence shows that a coronally advanced flap alone in many instances results in complete root coverage and is stable over time. A coronally advanced flap is less invasive for the patient, requires less chair-time and probably less surgical skill. It would therefore be desirable to use a coronally advanced flap approach when indicated. It has been hypothesized that a coronally advanced flap approach alone could be successfully applied when the residual gingiva is thick and wide, although existing evidence does not support this hypothesis in full. Accordingly, the adjunctive use of a graft or enamel matrix derivatives could be restricted to sites at which there is thin and narrow residual gingiva.
Pierpaolo Cortellini; Giovanpaolo Pini Prato
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Periodontology 2000     Volume:  59     ISSN:  1600-0757     ISO Abbreviation:  Periodontol. 2000     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-04-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9313276     Medline TA:  Periodontol 2000     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  158-84     Citation Subset:  D    
Copyright Information:
© 2012 John Wiley & Sons A/S.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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