head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2021, vol. 27, issue2
Subject Area: Dental Medicine
DOI: 10.5272/jimab.2021272.3784
Published online: 08 June 2021

Case report

J of IMAB. 2021 Apr-Jun;27(2):3784-3792
Kamen KotsilkovORCID logo Corresponding Autoremail,
Department of Periodontology, Faculty of Dental Medicine, Medical University Sofia, Bulgaria.

PURPOSE: This presentation demonstrates a modified surgical approach for multiple gingival recessions in sites with interdental papillae loss and a newly developed method for prediction of the possible root coverage
MATERIAL/METHODS: A 41 years old patient with a diagnosis of Periodontitis II Stage, Grade A. The main complaint was the hypersensitivity, which has even increased after the initial periodontal therapy and his chief request was to cover the exposed root surfaces. In order to achieve a harmonic gingival display and good esthetics, root coverage on all teeth from 13 to 25 was required. The surgical planning revealed a decreased height of interdental papillae. The analysis of the maximum achievable root coverage demonstrated that the intended line of coverage could not be reached with the available root coverage procedures. A new surgical technique, together with a new measuring protocol for accurate prediction of the achievable level of root coverage were developed.
RESULT: One year after treatment, a consistent root coverage was observed with an established proper gingival profile The achieved line of the gingival margin completely coincided with the presurgical planning. The patient was fully satisfied with the esthetic result and the reduction of the hypersensitivity.
CONCLUSION: In the limitation of the presented case, the developed new method for prediction of the root coverage and modified surgical approach for cases with interdental papillae loss and preserved isthmus provided a predictable increase of the achievable root coverage. Further research is required to study the efficiency of this newly developed surgical approach.

Keywords: interdental tissue loss, prediction of root coverage, papillary isthmus deepithelialization, modified root coverage surgical protocol,

pdf - Download FULL TEXT /PDF 4529 KB/
Please cite this article as: Kotsilkov K. Modified coronally advanced flap approach with isthmus deepithelialization for the treatment of multiple recession defects in cases with interdental tissue loss. J of IMAB. 2021 Apr-Jun;27(1):3784-3792. DOI: 10.5272/jimab.2021272.3784

Corresponding AutorCorrespondence to: Kamen Kotsilkov, DDS, PhD - Associate Professor, Department of Periodontology, Faculty of Dental Medicine, Medical University - Sofia; 1, St. GeorgiSofiiski str., Sofia, Bulgaria; Private Practice: Dental Clinic Kotsilkovi, 24,Vidinikuli str., Sofia, Bulgaria; E-mail: kamenkotsilkov@gmail.com

1. Dimova M. [Computerized occlusal analysis at maximum intercuspation in patients with bruxism and bruxomania. Preliminary report.] Problems of dental medicine. 2014 Jul;40(1):22-26. [in Bulgarian]
2. Konstantinova D, Dimova M, Naydenova D. Impact of food preferences on the development of pathological changes in the masticatory apparatus in young patients. J of IMAB. 2016 Jul-Sep;22(3):1230-1234. [Crossref]
3. Zucchelli G, Mele M, Stefanini M, Mazzotti C, Mounssif I, Marzadori M, et al. Predetermination of root coverage. J Periodontol. 2010 Jul;81(7):1019-26. [PubMed]
4. Zucchelli G, De Sanctis M. Treatment of multiple recession-type defects in patients with esthetic demands. J Periodontol. 2000 Sep;71(9):1506-14. [PubMed]
5. Miller PD Jr. A classificationofmarginaltissuerecession. Int J PeriodonticsRestorativeDent. 1985; 5(2):9-13. [PubMed]
6. Cairo F, Nieri M, Cincinelli S, Mervelt J, Pagliaro U. The interproximal clinical attachment level to classify gingival recession sand predict root coverage outcomes: an anexplorativeandreliability study. J ClinPeriodontol. 2011 Jul;38(7):661-6. [PubMed]
7. Aroca S, Barbieri A, Clementini M, Renouard F, deSanctis M. Treatmentofclass III multiple gingival recessions: Prognosticfactorsforachieving a complete root coverage. J ClinPeriodontol. 2018Jun;45(7):861-68. [PubMed]
8. Stefanini M, Marzadori M, Aroca S, Felice P, Sangiorgi M, Zucchelli G. Decision making in root-coverage procedures or the esthetic outcome. Periodontol 2000. 2018 Jun;77(1):54-64. [PubMed]
9. Zucchelli G, Mazzotti C, Tirone F, Mele M, Bellone P,Mounssif I. The connective tissue graft wall technique and enamel matrix derivative to improve root coverage and clinical attachment levels in Miller Class IV gingival recession. Int J Periodontics Restorative Dent. 2014 Sep-Oct;34(5):601-9. [PubMed]
10. Mounssif I, Stefanini M, Mazzotti C, Marzadori M, Sangiorgi M, Zucchelli G. Esthetic evaluation and patient-centred outcomes in root-coverage procedures. Periodontol 2000. 2018 Jun;77(1):19-53. [PubMed].

Received: 19 August 2020
Published online: 08 June 2021

back to Online Journal