Treatment of Gingival Recession-type Defects Using Different Restorative Materials
Condition: Gingival Recession; Tooth Abrasion
MeSH terms: Gingival Recession; Tooth Abrasion
Study type: Interventional

Summary: 
      Background: The aim of this study was to evaluate the treatment of multiple gingival
      recessions associated with non-carious cervical lesions (NCCL) using a modified coronally
      advanced flap in combination with a sub-epithelial connective tissue graft (SCTG) on restored
      root surfaces.

      Methods: Twenty-three systemically healthy subjects, who were positive for the presence of
      three cervical lesions associated with gingival recessions in three different adjacent teeth,
      were enrolled in the study. The NCCL were each restored prior to surgery by using one of
      three different materials: composite resin (group 1), resin-modified glass ionomer cement
      (group 2) or giomer (group 3). The defects were treated with SCTG. Clinical measurements,
      including plaque index (PI), bleeding on probing (BOP), relative recession height (rRH),
      probing depth (PD), cervical lesion height (CLH), relative clinical attachment level (rCAL),
      keratinized tissue height (KTH), keratinized tissue thickness (KTT), percentage of root
      coverage (RC), and percentage of cervical lesion height coverage (CLHC) were recorded at
      baseline, 3 and 6 months, and 1 year postoperatively.
    

Detailed description: 
      Gingival recession (GR) is defined as exposure of the root surface due to displacement of the
      gingival margin apical to the cemento-enamel junction (CEJ). Problems related to gingival
      recessions are dentin hypersensitivity, bacterial plaque accumulation, difficulty of
      maintaining oral health care and aesthetics, root caries and abrasions and fear of losing
      teeth6. Coronally advanced flap (CAF) is an effective periodontal plastic surgical procedure
      for the treatment of gingival recessions. The CAF with a subepithelial connective tissue
      graft (CAF+ SCTG) technique is reported as the gold standard and does enhance the probability
      of achieving complete root coverage.

      Various dental materials and surgical approaches have been used to manage gingival recessions
      associated with cervical lesions for the most predictable combined surgical/restorative
      treatment.Restorative materials must be biocompatible to minimize their adverse effects on
      periodontal tissues induced by direct contact.Resin composites or resin modified glass
      ionomer cements have been commonly used to restore cervical lesions.Resin-ionomer materials
      have many properties such as biocompatibility with soft and hard tissues and displaying high
      marginal adaptation and minimal surface roughness as well as allowing them to be used
      successfully in the subgingival region. Composite resin materials have many advantages
      including aesthetics and surface characteristics in terms of finishing and polishing.

      It has been reported that well-adapted and finished composite resins seem have no adverse
      effects on the periodontal margin. It has also been reported that the ageing of the composite
      resin restorations may produce gingival inflammation in subgingival areas. Fluoride-releasing
      resin materials with pre-reacted glass (PRG), called giomer, has been suggested to have good
      color matching, biocompatibility, smooth surface finish, fluoride release and fluoride
      recharge potential. It was reported in a randomized-controlled clinical trial that the use of
      CTG for treatment of root surfaces restored with giomer was effective over the 6-month period
      without any noxious effect on periodontal tissues.

      Therefore, the aim of this study was to evaluate clinically the treatment of gingival
      recession associated with NCCL in resin modified glass ionomer cement (RMGI) or nano-filled
      resin composite (NRC) or giomer plus SCTG in the first year following surgery.
    

Intervention name(s): connective tissue graft+composite resin; connective tissue graft+ glass ionomer; connective tissue graft+giomer
Intervention type(s): Procedure; Procedure; Procedure
Intervention description(s): treatment of gingival recession associated with cervical lesions with sub epithelial connective tissue graft plus composite resin; treatment of gingival recession associated with cervical lesions with sub epithelial connective tissue graft plus resin modified glass ionomer cement; treatment of gingival recession associated with cervical lesions with sub epithelial connective tissue graft plus giomer
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Cervical lesion; gingival recession; restorative materials