Treatment of Multiple Gingival Recession Defects Using Periosteal Pedicle Graft: A Case Series

Department of Periodontics, Himachal Pradesh Government Dental College, Shimla, Himachal Pradesh, India.
Journal of Periodontology (Impact Factor: 2.71). 10/2010; 81(10):1426-31. DOI: 10.1902/jop.2010.100134
Source: PubMed


The periosteum is a highly vascular connective tissue with immense regenerative potential. These qualities make it a suitable autogenous graft. A technique is described for using an autogenous periosteal pedicle graft (PPG) for the treatment of multiple gingival recession defects.
Twenty teeth in six subjects with Miller Class I and II recessions ≥ 2 mm were treated using PPGs. In addition to the depth of the gingival recession defect, the probing depth and widths of keratinized and attached gingiva were recorded. The mean +/- SD was calculated for each of the clinical parameters. The paired t test was used to test the significance of the change.
At the end of 1 year, 90.95% of root coverage was attained with a significant increase in the widths of keratinized and attached gingiva (P = 0.0001); no change was observed in probing depths (P = 0.36).
The PPG technique can be successfully used for the treatment of multiple gingival recession defects.

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Available from: Ajay Mahajan, Mar 15, 2014
    • "The periosteum has the potential to stimulate bone formation when used as a graft material in animal and human studies.[16171821222324252627] In an animal study, free grafts of periosteum taken from the tibia in rabbits were able to initiate bone and cartilage formation when placed in the anterior chamber of the eye and in the capsule of the kidney. "
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    ABSTRACT: Objective: The purpose of the study was to evaluate the clinical effectiveness of periosteum as a barrier membrane for the treatment of intrabony defects. Materials and methods: The study was conducted in patients having bilateral intrabony defects. A total of 20 intrabony defects in 10 patients were treated, out of which 10 defects received periosteal barrier and the other 10 defects received conventional open flap debridement procedure. The efficacy of the treatment was assessed using clinical parameters and dentascan. Results: Statistically significant gain in clinical attachment level (CAL) was found in the test group (2.00 ± 0.26 mm) as compared to the control group (0.60 ± 0.22 mm). In both the treatment modalities (test and control groups), a significant decrease in probing pocket depth of 3.90 ± 0.35 mm and 2.90 ± 0.31 mm was observed, respectively. The difference between the two groups was not statistically significant. Bone defect fill was 1.40 ± 0.16 mm for the test group and 0.90 ± 0.18 mm for the control group, but the difference observed was not statistically significant. Conclusion: The results of this study show that periosteal barrier membrane can be a better alternative of barrier membranes for the treatment of intrabony defects.
    Journal of Indian Society of Periodontology 05/2014; 18(3):331-5. DOI:10.4103/0972-124X.134571
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    • "In all age groups, the cells of the periosteum retain the ability to differentiate into various cells. [11]. On the basis of these observations, it can be hypothesized that the periosteal membrane can contribute to the stimulation of new bone formation and has an immense potential for regeneration. "
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    ABSTRACT: Radicular cysts are the most common cystic lesions affecting the jaws. They are most commonly found at the apices of the involved teeth. This condition is usually asymptomatic but can result in a slow-growth tumefaction in the affected region. The following case report presents the successful treatment of radicular cysts using autologous periosteum and platelet-rich fibrin with demineralized freeze-dried bone allograft.
    08/2013; 2013(3):893791. DOI:10.1155/2013/893791
    • "Gingival recession displaces the gingival margin apically, reducing the vestibular depth, which is measured from the gingival margin to the bottom of the vestibule. Multiple techniques have been developed to obtain predictable root coverage; however, need for a graft that has its own blood supply, which can be harvested adjacent to the recession defect in sufficient amounts without requiring any second surgical site and has the potential for promoting the regeneration of lost periodontal tissue, is a long-felt need.[3] "
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    ABSTRACT: Gingival recession along with reduced width of attached gingiva and inadequate vestibular depth is a very common finding. Multiple techniques have been developed to obtain predictable root coverage and to increase the width of attached gingiva. Usually, the width of gingiva is first increased and then the second surgery is caried out for root coverage. The newer methods of root coverage are needed, not only to reconstruct the lost periodontal tissues but also to increase predictability, reduce the number of surgical sites, reduce the number of surgeries and improve patient comfort. Hence, this paper describes a single stage technique for increasing the width of attached gingiva and root coverage by using the periosteal pedicle flap.
    Journal of Indian Society of Periodontology 03/2013; 17(2):265-70. DOI:10.4103/0972-124X.113095
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