Management of advanced gingival recession defects in mandibular anterior teeth using gingival unit graft - Case Series
Dr.Anupama Tadepalli, Dr. Swapna Chekurthi, Dr.Harinath Parthasarathy, & Dr.Deepa PonnaiyanObjectives:Gingival recession leads to exposure of the root surface of the tooth due to apical migration of marginal gingiva relative to the cement-enamel junction.The increased incidence of recession has become a major concern for clinicians as dentinal hypersensitivity, esthetic issues and root caries are often associated with root exposure. Free gingival grafts are commonly used to augment attached gingiva. Gingival unit transfer is a variant of free gingival graft that was used in this case series to increase the width of attached gingiva simultaneously improving root coverage.Methods: This case series describes the clinical effectiveness of a gingival unit graft harvested from palate, in the treatment of RT2 gingival recession defects with respect to mandibular anterior teeth in three subjects. Clinical parameters such as recession depth (RD), width of attached gingiva (WAG) and keratinized tissue (KTW) were evaluated at baseline and post surgery. Root coverage percentage (RC%) was calculated at the end of each follow up period respectively. Results:At the end of the two-year follow-up period, patient 1 had 100% root coverage. At 18 months, patient 2 had partial root coverage ranging from 50 to 75% in different sites. Complete marginal root coverage was attained in patient 3 at 6 months without significant improvement in papillary height. KTW and WAG were improved in all individuals, along with gain in clinical attachment. Conclusion: GUT treatment resulted in improvement in KTW and vestibular depth with varied percent of root coverage in advanced mandibular recession defects.