مقايسه تاثير كلينيكي ROOT PLANING و POLISHING در پوشش ريشه هاي عريان باروش پيوند بافت همبندي زير مخاط

Subepithelial Connective Tissue Graft Procedure for root coverage. Polishing Versus Root Planing

Background & Aim: This prospective clinical controlled randomized trial was designed to determine wheather mechanical instrumentation (root planing) of the exposed root is useful in treating gingival recession caused by traumatic toothbrushing following subepithelial connective tissue graft (SECTG). Method & Materials: Patients with high levels of oral hygiene (full-mouth plaque score <10%), were selected for the study. Each patient had two class I or class H Miller recessions in two quadrants. A total of 26 recessions were treated. In each patient, one recession was randomly assigned to the test group and the another one to the control group. In the test group the exposed root surface was polished at slow (2000/min) speed with a rubber cup and prophylaxis paste for 60 seconds. In the control group, the exposed root surface was planed with a sharp curret in both test and control groups. A trapezoidal partial-thickness flap was elevated and the harvested connective tissue graft from molar/premolar region of the palate, placed under flap and sutured. The flap coronally positioned as high as possible to completely immerse the graft and was secured with sling sutured. Recession height, clinical attachment level, height of keratinized gingiva, probing depth were taken by Williams Probe and acrylic stent. Results: Before treatment, the mean recession depth, recession width, width of keratinized tissue, probing depth and clinical attachment level were, 2.96-3.85-2.5-1.15-4.15 mm and in the test group were 3-3.77-2.15-1.19-4.12 mm respectively. Mean of these parameters 3 months after treatment changed 0.69, 2.15, 1.46, 2.96,2.08 mm in the control group and 1.04, 2.81, 3.12, 1.54, 2.58 mm in the test group respectively. Also the covered surface area of root were 10.7±4.3 mm2 in the control and 10.5±2.8 mm2in the test group. Mean gain of root coverage was 76.7%in the control and 65.3% in the test group. A statistically significant reduction in recession depth, recession width, and clinical attachment level were observed in the both groups before and after 3 months of treatments, but there was not statistically significant differences between tests and controls (P<0.2) Conclusion: It was concluded that root coverage and reduced hypersensitivity could be obtained with both polishing and root planing procedures in the patients with high levels of oral hygiene after 3 months.