TARRSON FAMILY ENDOWED CHAIR IN PERIODONTICS

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TARRSON FAMILY ENDOWED CHAIR IN PERIODONTICS
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UCLA SCHOOL OF DENTISTRY
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Presents
Presents
Dr. E. Barrie KenneyProfessor ChairmanSection
of Periodontics
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E. Barrie Kenney B.D.Sc., D.D.S., M.S.,
F.R.A.C.D.S.
Tarrson Family Endowed Chair in Periodontics.
Professor and Chairman Division of Associated
Clinical Specialties UCLA School of Dentistry
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Connective Tissue Graft
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Treatment of Gingival Recession
Adequate Adjacent Donor Site
Adequate Palatal Donor Site
Adequate Keratinized Gingiva
Recession More than 2 mm.
Esthetic Problem
Yes
Yes
Yes
No
No
Adequate Keratinized Gingiva
Yes
No
Yes
No
No
Connective Tissue Graft
Coronally Repositioned Semi-Lunar Flap
Lateral Sliding Flap
Gingival Graft for Root Coverage or Gingival
Graft and Coronally Repositioned Flap
Yes
No
Coronally Repositioned Flap with Membrane or
Emdogain
3 Month Evaluation for Progression
Gingival Graft
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Treatment of Gingival Recession
Adequate Adjacent Donor Site
Adequate Palatal Donor Site
Adequate Keratinized Gingiva
Recession More than 2 mm.
Esthetic Problem
Yes
Yes
Yes
No
No
Adequate Keratinized Gingiva
Yes
No
Yes
No
No
Connective Tissue Graft
Coronally Repositioned Semi-Lunar Flap
Lateral Sliding Flap
Gingival Graft for Root Coverage or Gingival
Graft and Coronally Repositioned Flap
Yes
No
Coronally Repositioned Flap with Membrane or
Emdogain
3 Month Evaluation for Progression
Gingival Graft
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Smoking and Root Coverage with Connective Tissue
Grafts

• 18 Recessions in 15 Patients
• 7 smokers, 8 non-smokers
• Clinical evaluation at 30, 60, 90 and 120 days
  post surgery

• Smoking may affect root coverage outcome. A
  prospective clinical trial in humans.
• Martins A.G. et al
• J. Periodontol. 2004 75586

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• Root Resorption assosiated with a subepithelial
  connective tissue graftClinical and histologic
  report of a case.

• 2 year post surgery
• Clinically successful
• Patient changed to full denture
• Conventional surgery
• 50 citric acid for 3 minutes

Int. J. Periodont. Rest. Dent. 2003, 4391
Carnio J,Camargo P.M, Kenney E.B.
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Connective Tissue Graft Plus Emdogain

• 4 upper teeth with
• Miller class II or III recession
• Connective tissue graft plus Emdogain
• Root treated with EDTA for 2 minutes
• 2 sectioned at 6 months, 2 at 1 year
• Light microscopy
• Notch placed above bone crest

• Histological evaluation of 4 cases with root
  coverage following a connective tissue graft
  combined with an Enamel Matrix Derivative
  Preparation
• Carnio J, Camargo, P.M., Kenney, E.B., Scheak,
  R.K.
• J. Periodontol. 2002 731534

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Gingival Recession

• All teeth obtained root coverage
• Connective tissue adjacent to root
• 1 case of new cementum
• after 6 months
• No significant new bone formation
• No long junctional epithelium

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6 MONTH
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6 MONTH
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1 YEAR
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A l l o D e r m

• Basement membrane side white, rough and dull
• Collagen elastin and ground substance
• No epithelium
• Vessels intact
• All donors
• Negative for HIV, hepatitis B C, syphilis

• Processed human skin
• Developed in 1994 for burns
• Cells removed
• Antiviral treatment
• Freeze-dried
• Dermal side red, shiny

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A short-term and long-term comparison of root
coverage with an acellular dermal matrix and a
subepithelial graft Harris RJ, J Periodont
2004, 75734

• 25 patients
• Evaluated at 12 to 13 weeks
• and 48 to 49 months
• Non-random assignment

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P e r c e n t a g e o f R o o t C o v e r a
g e
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UCLA SCHOOL OF DENTISTRY
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