3. Presents
Dr. E. Barrie Kenney
Professor & Chairman
Section of Periodontics
3
4. E. Barrie Kenney B.D.Sc., D.D.S., M.S., F.R.A.C.D.S.
Tarrson Family Endowed Chair in Periodontics.
Professor and Chairman Division of Associated Clinical Specialties UCLA
School of Dentistry
6. Treatment of Gingival Recession
Adequate Recession More Adequate Adequate
Esthetic Problem Yes Yes Yes Adjacent No Palatal
Keratinized than 2 mm.
No Gingiva Donor Site Donor Site
Adequate No Yes
Keratinized Yes
No No
Connective
Gingiva Coronally
Gingival Graft for Root Lateral Tissue Graft
Yes No Repositioned Sliding
Coverage or Gingival Graft Coronally
Semi-Lunar Flap Flap
3 Month and Coronally Repositioned Repositioned
Evaluation for Gingival Flap Flap with
Progression Graft Membrane or
Emdogain
7. Treatment of Gingival Recession
Adequate Recession More Adequate Adequate
Esthetic Problem Yes Yes Yes Adjacent No Palatal
Keratinized than 2 mm.
No Gingiva Donor Site Donor Site
Adequate No Yes
Keratinized Yes
No No
Connective
Gingiva Coronally
Gingival Graft for Root Lateral Tissue Graft
Yes No Repositioned Sliding
Coverage or Gingival Graft Coronally
Semi-Lunar Flap Flap
3 Month and Coronally Repositioned Repositioned
Evaluation for Gingival Flap Flap with
Progression Graft Membrane or
Emdogain
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37. Smoking and Root
Coverage with Connective
Tissue Grafts • 18 Recessions in 15 Patients
Smoking may affect root coverage • 7 smokers, 8 non-smokers
outcome. A prospective clinical • Clinical evaluation at 30, 60,
trial in humans. 90 and 120 days post surgery
Martins A.G. et al
J. Periodontol. 2004 75:586
38. Non Smokers Smokers
Percent Root Coverage
74.73 58.84
Attachment Level Gain
2.54 2.00
39. Root Resorption assosiated with a
subepithelial connective tissue • 2 year post surgery
graft:Clinical and histologic report • Clinically successful
of a case. • Patient changed to full denture
• Conventional surgery
Int. J. Periodont. Rest. Dent. 2003, 4:391
• 50% citric acid for 3 minutes
Carnio J,Camargo P.M, Kenney E.B.
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42. Connective Tissue Graft
Plus Emdogain • 4 upper teeth with
Miller class II or III recession
Histological evaluation of 4 cases with root • Connective tissue graft plus Emdogain
coverage following a connective tissue graft
combined with an Enamel Matrix Derivative • Root treated with EDTA for 2 minutes
Preparation • 2 sectioned at 6 months, 2 at 1 year
• Light microscopy
Carnio J, Camargo, P.M., Kenney, E.B., Scheak,
R.K.
• Notch placed above bone crest
J. Periodontol. 2002 73:1534
43. Gingival Recession
• All teeth obtained root coverage Original 6 months 1 year
• Connective tissue adjacent to root
4 0
• 1 case of new cementum
after 6 months 6 2
• No significant new bone formation
5 1
• No long junctional epithelium
6 3
50. AlloDerm
• Processed human skin •Basement membrane side white, rough and dull
• Developed in 1994 for burns •Collagen elastin and ground substance
• Cells removed •No epithelium
• Antiviral treatment •Vessels intact
• Freeze-dried •All donors
• Dermal side red, shiny Negative for HIV, hepatitis B & C, syphilis
51. A short-term and long-term
comparison of root coverage • 25 patients
with an acellular dermal matrix
and a subepithelial graft • Evaluated at 12 to 13 weeks
and 48 to 49 months
Harris RJ, • Non-random assignment
J Periodont 2004, 75:734
