Effectiveness of Plasma-Rich Fibrin and De-Epithelialized Free Gingival Graft in the Treatment of Gingival Recessions.

Introduction/Aim: Soft tissue dehiscences such as gingival recessions are a very common problem that we face in modern periodontics. This clinical study aimed to analyze the effectiveness of surgical procedures using a de-epithelialized gingival graft (DGG) combined with a coronally advanced flap and to evaluate the application of plasma-rich fibrin (PRF). Methods: The study included 40 teeth (20 patients) with Miller class I and II gingival recessions. Twenty recessions (20 patients) were treated utilizing the de-epithelialized gingival graft in combination with the coronally advanced flap, and on the opposite side of the jaw, the same number of recessions were treated utilizing plasma-rich fibrin combined with the coronally advanced flap. To evaluate tissue condition and the clinical parameters before and after the surgical procedure, the following parameters were used: the degree of epithelial attachment (DEA), the width of keratinized gingiva (WKG), and the vertical depth of recession (VDR). Results: based on the achieved results and the analysis of clinical parameters, a statistically significant reduction in the vertical depth of recession was proven in both groups, with very similar mean percentages of root coverage, with the difference being that the stability of the soft tissues of the treated region was more visible in the DGG. Conclusion: using modern surgical procedures allows the regeneration of not only the soft tissues but also deeper periodontal tissues.

Reliability and validity of the Serbian version of Children's Dental Fear Questionnaire.

BACKGROUND/AIM: Dental anxiety leads to avoidance of dental treatment and could lead to impaired oral health. The aim of this study was to determine the reliability of the Serbian version of Children's Fear Survey Schedule Dental Subscale (CFSS-DS) and the relations between dental anxiety and oral health status in a sample of Serbian schoolchildren. METHODS: The CFSS-DS scale was translated into Serbian and administered to 231 (12-year old) patients of the Pediatric Dental Department, Public Health Center Cukarica, Belgrade. The number of healthy, decayed, missing and filled teeth (DMFT score) in children was determined by a clinical exam. RESULTS: The average CFSS-DS score was 26.47 ± 10.33. The girls reported higher anxiety than the boys (p < 0.05). Most common fears were drilling, choking, going to the hospital and anesthesia. Lower CFSS-DS scores were recorded in children with all healthy teeth (p < 0.05). Children with higher CFSS-DS scores mostly visit the dentist due to pain or parental insistence, and those with lower anxiety scores more often visited dentist due to regular check-ups or non-invasive treatments (p < 0.01). A high value of the Cronbach's coefficient of internal consistency (α = 0.88) was found in the entire scale. CONCLUSION: The Serbian version of CFSS-DS questionnaire is reliable and valid psychometric instrument for evaluation of dental fear in Serbian children. Dental anxiety negatively affects dental attendance and oral health of the examined schoolchildren.

Therapeutic efficacy of connective tissue autotransplants with periosteum and platelet rich plasma in the menagement of gingival recession.

BACKGROUND/AIM: Gingival recession progression in clinical practice has influenced the development of various surgical procedures and techniques for solving esthetic imperfections and subjective difficulties coused by gingival recession. The aim of this study was to verify efficacy of surgical procedures and to compare both of surgical procedures through the keratinized tissue width. METHODS: The study included 20 teeth with gingival recesion, Müller class I and II. Ten teeth with gingival recession were treated with connective tissue autotransplants with periosteum in combination with coronary guided surgical flap (CTG group). On the contralateral side 10 teeth with gingival recession were treated with the same surgical procedures but in combination with platelet-rich plasma (CTG-PRP group). We measured the keratinized tissue width. For statistical significance we used the Student's t-test. RESULTS: The study reveled a statistical significance in reducing vertical deepress of recession by both used treatments. Root deepness in CTG and CTG-PRP group was 90% and 93.5%, respectively. With both surgical techniques we achieved larger zone of keratinized gingiva but with a wide zone of keratinized tissue in CTG--the PRP group. CONCLUSION: The concept regeneration technique with PRP and with the stimulating influence of platele activated growth factors results in the regeneration of deep periodontal tissue as an important prerequisite for the successfull treatment of gingival recession.

[Therapeutic efficacy of guided tissue regeneration and connective tissue autotransplants with periosteum in the management of gingival recession].

BACKGROUND/AIM: Gingival recession progression in clinical practice as an ethiological factor of periodontal diseases, and symptoms of the disease have caused the development of various surgical procedures and techniques of the reconstruction of periodontal defects. The aim of this study was to verify efficacy of surgical procedures that include connective tissue autotransplants with periosteum and guided tissue regeneration for the treatment of gingival recession. METHODS: The study included 20 teeth with gingival recession, Müller class II and III. Ten teeth with gingival recession were treated with resorptive membrane and coronary guided surgical flap (GTR group). On the contralateral side 10 teeth with gingival recession were treated with connective tissue autotransplants with periosteum in combination with coronary guided surgical flap (TVT group). We measured the degree of epithelial attachment (DEA), width of subgingival curettage (WGC) and vertical deepness of recession (VDR). For statistical significance we used Student's t-test. RESULTS: The study revealed statistical significance in reducing VDR by both used treatments. Root deepness in GTR and TVT group was 63.5%, and 90%, respectively. With both surgical techniques we achieved coronary dislocation of the epithelial attachment, larger zone of gingival curettage, and better oral hygiene. CONCLUSION: Current surgical techniques are effective in the regeneration of deep periodontal spaces and the treatment of gingival recession. Significantly better results were achieved with the used coronary guided surgical flap than with guided tissue regeneration.