Root Coverage Surgery Treatment To Miller Class ? Gingival Recession

Background:Gingival recession is one of the most common dental clinical symptoms among adults,which could lead to esthetic problems,tooth sensitivity,root caries and root abrasions.Miller divided gingival recession level to four Classes back in 1985,in which the Class ? and ? are defines as without interdental bone and attachment loss.These kinds of gingival recession are commonly existed in young adults.Until now,a large body of evidence demonstrates that root coverage surgeries are effective in the treatment of gingival recession without any interdental bone loss.Among all,coronal advanced flap,subepithelial connective tissue graft showed the highest probability to obtain complete root coverage.Also there are some studies illustrate that coronal advanced flap has already gained successful long-term results for most Miller Class ? or ? gingival recessions.On the other side,adding connective tissue graft actually will create a new wound bed,which should take into consideration.For another hand,some gingival recession accompanies wedge-shaped defect,it should be decided whether to use conservation treatment only or with plastic surgery,or maybe just plastic surgery available.These issues are all under discussion.Aim:Miller Class ? gingival recession patients were treated with root coverage procedures of coronal advanced flap with or without subepithelial connective tissue graft.The outcomes are evaluated afterward.Method:Total of 5 patients diagnosed as Miller Class I gingival recession were enrolled at the outpatient of department of Periodontology,second affiliated hospital of Zhejiang university school of medicine.They all treated with root coverage surgeries afterwards.Dental histories and intra-oral photos were taken,recession depth were detected by a UNC-15 periodontal probe,all data are compared before and after surgeries,patients' reflection to the treatment were also under evaluation.Results:two weeks after surgery,all patients experienced gingival hyperemia and welling without hemorrhage and infection.Wound beds were all healing well.After more than four months after-surgery follow-up,no more root hypersensitivity and other symptoms were complained heard.No gingival hyperemia and welling.Gingival margin levels were all stable.All patients' gained successful root coverage results,with thicker and wider keratinized gingiva.The group of CAF+SCTG showed higher success than the group of CAF alone,especially in terms of the thickness and width of keratinized gingiva.Conclusion:Both CAF and CAF+SCTG are effective for miller class ? gingival recession.Thickness and width of keratinized gingiva upraised and exposed root surface covered more than before.While after CAF+SCTG surgery,gingival flaps shrink less,show more stability and gain more keratinized gingiva of thickness and width.