Clinical characteristics of the results of treatment of patients with gingival recession
DOI:
https://doi.org/10.11603/2311-9624.2023.4.14499Keywords:
gingival recession, hygienic indices, periodontal indicesAbstract
Summary. A thorough analysis of literature sources on the treatment of gum recession allowed us to identify natural products with plastic-stimulating action, containing hyaluronic acid, collagen, elastin, etc., and their synthetic analogues. Such drugs, thanks to special anti-inflammatory properties, accelerate wound healing, reduce swelling and pain, improve regeneration and have a positive effect on osteoinduction; in augmentation surgery, they play the role of biological membranes, which is due to the slow absorption of these drugs. Among the undeniably important properties of plastic-stimulating drugs, it should be noted: improvement of microcirculation, acceleration of the processes of removal of decay products and toxins, increased metabolism, improvement of local immunity, antibacterial effect.
The aim of the study – to evaluate the clinical effectiveness of the hyaluronic acid preparation in the treatment of patients with gingival recession.
Materials and Methods. The study included 48 patients aged 28–54 years with gum recession, who were randomly selected and divided into the main group – 28 patients (at the stage of maintenance therapy, the drug "Hyadent BG" was used by micropapular injections into the gums with a fine needle according to the instructions) and the control group – 20 patients with gum recession without the use of plastic stimulating drugs at the stage of maintenance therapy.To study the intensity and prevalence of the inflammatory process in the gums, we used a modified method of determining the papillary-marginal-alveolar index (PMA), the bleeding index of the gums was determined by probing according to H.R. Mühlemann (Ikr), the loss of gingival epithelial attachment (GEP) was determined according to the method of G.F. Biloklytska (2010). After treatment, the state of the periodontal tissues was assessed according to the criteria of "normalization", "improvement", "no change". The hygienic condition of the oral cavity was determined by the hygiene indices (OHI-S), the O'Leary gingival irritation index (IP) and the hygiene efficiency index (IEG). We determined the indices of the prevalence of tooth hyperesthesia (IHRZ) and the intensity of tooth hyperesthesia (IIHZ).
Results and Discussion. 6 months after the treatment of patients with gum recession, there was an improvement in the state of oral hygiene according to the OHI–S index: in the control group by 1.3 times, in the main group by 1.8 times from the indicator before treatment. In the patients of the main group, the PI was reliably 1.1 times lower than the initial data and 1.3 times lower than the indicator of the control group (p<0.05). The oral hygiene efficiency index (IEG) decreased by 1.6 times from baseline to treatment (p<0.05) in the treatment of gingival recession with "Hyadent BG".The examination showed a significant decrease in dental hyperesthesia after 6 months of clinical observation. The value of IRGZ in patients of the main group was 3.6 times, in patients of the control group – 1.3 times lower compared to the data before treatment.The value of the PMA index was significantly lower compared to the values before treatment: when using the hyaluronic acid preparation – by 4 times, in patients of the control group – by 1.6 times. The index of bleeding gums when using "Hyadent BG" was significantly lower compared to the data before treatment (p<0.05). the gingival recession index (GRI) decreased by 2.1 times (p<0.05), the loss of epithelial attachment (EP) decreased by 16.8 % (p<0.05).Clinical assessment of periodontal tissues showed that "normalization" of periodontal tissues was diagnosed in 5 patients (20 %) of the control group and in 22 (78.6 %) treated with "Hyadent BG"; "improvement" of the state of periodontal tissues was determined in 7 (35 %) of the treated control group and in 6 (21.4 %) – when using "Hyadent BG".
Conclusions. The conducted studies showed that in the long-term follow-up of patients with gum recession who underwent plastic stimulation therapy "Hyadent BG", the clinical condition of the periodontal tissues in all patients normalized and improved. Thus, for the treatment of gum recession, complex treatment should include plastic-stimulating drugs to obtain better results.
References
Kassab, M.M., & Cohen, R.E. (2016). The etiology and prevalence of gingival recession. Journal of the American Dental Association. 134(2), 220-225. PMID: 12636127. DOI: 10.14219/jada.archive.2003.0137. DOI: https://doi.org/10.14219/jada.archive.2003.0137
Albandar, J.M., & Kingman, A. (1999). Gingival recession, gingival bleeding, and dental calculus in adults 30 years of age and older in the United States, 1988–1994. J. Periodontol., 70, 30-43. DOI: https://doi.org/10.1902/jop.1999.70.1.30
Armitage, G.C. (1999). Development of a classification system for periodontal diseases and conditions. Ann. Periodontol., 4, 1-6. DOI: https://doi.org/10.1902/annals.1999.4.1.1
Chan, H.L., Chun, Y.H., MacEachern, M., & Oates, T.W. (2015). Does gingival recession require surgical treatment? Dent. Clin. North Am., 59, 981-996. DOI: https://doi.org/10.1016/j.cden.2015.06.010
Lang, N.P., & Löe, H. (1972). The relationship between the width of keratinized gingiva and gingival health. J. Periodontol., 43, 623-627. DOI: https://doi.org/10.1902/jop.1972.43.10.623
Kennedy, J.E., Bird, W.C., Palcanis, K.G., & Dorfman, H.S. (1985). A longitudinal evaluation of varying widths of attached gingiva. J. Clin. Periodontol., 12, 667-675. DOI: https://doi.org/10.1111/j.1600-051X.1985.tb00938.x
Chambrone, L., & Tatakis, D.N. (2015). Periodontal soft tissue root coverage procedures: a systematic review from the AAP Regeneration Workshop. J. Periodontol., 86(2), S8-S51. DOI: https://doi.org/10.1902/jop.2015.130674
Heasman, P.A., Holliday, R., Bryant, A., & Preshaw, P.M. (2015). Evidence for the occurence of gingival recession and non-carious cervical lesions as a consequence of toothbrushing. J. Clin. Periodotontol., 42(16), S237-S255. DOI: https://doi.org/10.1111/jcpe.12330
Joss-Vassalli, I., Grebenstein, C., Topouzelis, N., Sculean, A., & Kastros, C. (2010). Orthodontics therapy and gingival recession: a systematic review. Orthod. Craniofac. Res., 13, 127-141. DOI: https://doi.org/10.1111/j.1601-6343.2010.01491.x
Cairo, F., Pagliaro, U., & Buti, J. (2016). Root coverage procedures improve patient aesthetics. A systematic review and Bayesian meta-analysis. J. Clin. Periodontol., 43, 965-975. DOI: https://doi.org/10.1111/jcpe.12603
Miller, P.D. Jr. (1985). Root coverage using the free soft tissue autograft following citric acid application. III. A successful and predictable procedure in areas of deep-wide recession. Int. J. Periodontics Restorative Dent., 5, 14-37.
Douglas de Oliveira, D.W., Oliveira-Ferreira, F., Flecha, O.D., & Gonçalves, P.F. (2013). Is surgical root coverage effective for the treatment of cervical dentin hypersensitivity? A systematic review. J. Periodontol., 84, 295-306. DOI: https://doi.org/10.1902/jop.2012.120143
Kim, D.M., & Neiva, R. (2015). Periodontal soft tissue non-root coverage procedures: a systematic review from the AAP Regeneration Workshop. J. Periodontol., 86(2), S56-S72. DOI: https://doi.org/10.1902/jop.2015.130684
American Academy of Periodontology (2000). Parameters on mucogingival conditions. J. Periodontol.,71(5), 861-862. DOI: https://doi.org/10.1902/jop.2000.71.5-S.861
American Dental Association (2015). For the dental patient. Gingival Recession: Causes and Treatment. JADA, 138 (10), 1404. PMID: 17908856.
DOI: 10.14219/jada.archive.2007.0058. DOI: https://doi.org/10.14219/jada.archive.2007.0058
Avdyeyev, O.V., & Iskiv, M.O. (2018) Otsinka hihiyenichnoho stanu porozhnyny rota ta hiperesteziyi zubiv u patsiyentiv z retsesiyeyu yasen [Evaluation of the hygienic condition of the oral cavity and dental hyperesthesia in patients with gingival recession]. Novyny stomatolohiyi – Dentistry News, 3(96), 14-17 [in Ukrainian].
Danylevskyy, M.F., Borysenko, A.V, & Antonen- ko, M.Yu. (2018). Terapevtychna stomatolohiya: pidruchnyk: U 4 t. T. 3. Zakhvoryuvannya parodonta [Therapeutic stomatology: textbook: In 4 vols. Vol. 3. Periodontal disease]. Kyiv : Medytsyna [in Ukrainian].
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