Clinical and complementary evaluation of the healing process in plastic muco-gingival surgery

Authors: Maria Rotaru, Silvia Martu

Abstract:

Traditional periodontal treatment, be it surgical or not, involves the instrumentation of the inflamed dentogingival
complex, leading to the lesion (wounding) of the already inflamed periodontal tissues. Thus, the consequences of such therapeutic procedures depend, to a great extent, on the molecular and cell events associated with the healing of the wounds. Scope of the study: This study was designed to assess the healing phenomenon and the recurrence odds following the plastic muco-gingival surgical procedures: coronally repositioned flaps and the addition of connective tissue grafts.
Material and method: The research was performed on a group of 18 patients who came to the Department of Periodontology of the Faculty of Medical Dentistry of Iasi with gingival recessions localized on 1 or 2 teeth and who were subject to flap procedures (9 patients) and to additions of connective tissue grafts (9 patients). Sections of the marginal gingiva were performed before and after the surgical procedure in order to thoroughly assess the parameters of the healing process for both types of procedures.
Results: 2 months postoperatively we noticed a more significant conservation of the tissue gain, registered after the surgery, through the use of connective tissue grafts. Tissue healing is complete for this type of procedure. We observed, at the same time, a considerable gain in the dimension of the attached gum, with the correction of the muco-gingival defect, as well as a more edifying histological image for the healing process.
Conclusions: The phenomena involved in the mucogingival healing process are very complex and sensitive to a variety of internal and external factors. The addition of connective tissue grafts (partial thickness grafts) is a procedure which, although it initially causes pain and more severe inflammation than the technique of the coronally repositioning of the flap, triggers a faster and a more efficient remission of the postoperative phenomena.

Keywords:
  • muco-gingival defects
  • postoperative tissue healing.
  • surgical procedures