Comparative research concerning clinical efficiency of three surgical methods of periodontium recessions treatment in five-year observations


Dominiak M, Konopka T, Lompart H, Kubasiewicz P


Abstract


Purpose: The aim of this study was a comparative analyses of clinical treatment efficiency of periodontium recessions after the application of double pedicle bilateral flap (DPBF), coronally repositioned flap in combination with connective tissue graft (CRF-CTG), coronally advanced flap in combination with guided tissue regeneration using collagen membranes (GTR-CM).

Material and methods: Research material consisted of 37 people (71.2% of initial patient number), including 27 women at the age from 17 to 53. All those people had single or multiple recessions, in I or II Miller’s class, with the depth more than 2 mm. There were estimated 98 covered recessions of which 33 after DPBF, 41 after CRF-CTG and 24 after GTR-CM.

The clinical estimation of recession level before surgeries and after 12, 24, 60 months was done with the usage of the following parameters: recession depth (RD), recession width (RW), clinical attachment level (CAL) and keratinized tissue hight (HKT). There was also done an ultrasonic measurement of keratinized tissue thickness (TKT) in two groups of patients who had undergone surgeries CRF-CTG and GTR-CM. After 12, 24 and 60 months there were measured: an average percentage of a root coverage (%ARC), a percentage index of the complete root coverage (%CRC) and the percentage of complete coverage (CRC).

Results: Five-year inter group analyses of three surgical methods of recession treatment did not show any significant differences among surgeries for the following parameters: RD, CAL and TKT. The value of RD after DPBF was 0.85 mm, after CAF-CTG was 0.83 mm and after GTR-CM 0.38 mm.

There was a substantial difference of values such as ARC the best result of which was for the method GTR-CM (90%) and next for CRF-CTG (82%), CRC% and CRC with the best result for the methods GTR-CM (90%; 87.5%) and CRF-CTG (82.8%; 61%).

Conclusions: The authors’ observations show that methods GTR-CM and CRF-CTG are mostly predictable and enable the stable coverage of periodotium recession during five-year observations.


Key words: periodontium recession, surgical treatment, five-year observations.