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Case Reports
. 2020 Sep 30:2020:3892753.
doi: 10.1155/2020/3892753. eCollection 2020.

A Modified Bilaminar Technique with the Use of a Fibrin-Fibronectin System for a Single Gingival Recession: A Case Report with a Follow-Up of 3 Years

Michele Perelli  1 , Paolo Giacomo Arduino  2 , Mario Semenza  3 , Roberto Abundo  1 , Hector Sarmiento  4
Affiliations
Case Reports

A Modified Bilaminar Technique with the Use of a Fibrin-Fibronectin System for a Single Gingival Recession: A Case Report with a Follow-Up of 3 Years

Michele Perelli et al. Case Rep Dent. .

Abstract

This case report described a modified bilaminar technique for treating a single gingival recession. Patient presented a gingival recession in a maxillary canine. Tooth was in a buccally prominent position and soft keratinized tissue apical to the recession was reduced but still present. A split-full-split thickness trapezoidal flap was designed. Root's surface was prepared with curettes. Epithelial-connective tissue graft was harvested from the palate with reduced dimension. After deepithelialization, the graft was placed with a fibrin-fibronectin system at the maximum root coverage level, and the flap coronally advanced and sutured. At 3-year follow-up control, the free gingival margin was still stable at the postsurgery position, with a thicker biotype corresponding to the grafted area, with no probing and a suitable aesthetic result.

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Conflict of interest statement

The authors report no declarations of interest.

Figures

Figure 1
Figure 1
Left maxillary canine presenting a RT2 gingival defect.
Figure 2
Figure 2
Lateral view: noncarious cervical lesion with composite restoration is evident (note the radicular concavity).
Figure 3
Figure 3
A minimum amount of keratinized tissue apical to the recession is still present.
Figure 4
Figure 4
The composite restoration is reshaped at the maximum root coverage level.
Figure 5
Figure 5
A trapezoidal flap is designed with vertical releasing incisions arriving just at the mucogingival junction.
Figure 6
Figure 6
Two horizontal releasing incision are done: one deep, parallel to the bone crest and one, more extended, more superficial parallel to the oral mucosa (note the elasticity of the mucosa).
Figure 7
Figure 7
Root surface is treated with curettes and anatomical papillae deepithelialized.
Figure 8
Figure 8
An epithelial-connective tissue graft is harvested. The height is 4 mm, and the length corresponds to the root width plus 3 mm.
Figure 9
Figure 9
The connective tissue graft is attached with the fibrin-fibronectin glue to the root at the MRC level.
Figure 10
Figure 10
Note the thickness of the CTG bonded to the root.
Figure 11
Figure 11
The flap has been coronally advanced and sutured.
Figure 12
Figure 12
Healing of the flap after 15 days, at sutures removal.
Figure 13
Figure 13
Palatal donor site healing after 15 days.
Figure 14
Figure 14
3-year lateral view (note the thickness of the soft tissue corresponding to the grafted area).
Figure 15
Figure 15
3-year buccal view (note the stability of the gingival margin, the partial root coverage achieved and the aesthetic blending of the area).
See this image and copyright information in PMC

References

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