Dişeti Çekilmelerinin Tedavisinde Koronale Pozisyone Flep Tekniği ile Tünel Tekniğinin Etkinliklerinin Karşılaştırılması

Dişeti çekilmesi (DÇ), dişeti kenarının mine sement sınırına (MSS) göre apikale kayması ve kök yüzeyinin ağız ortamına açılması olarak tanımlanır. DÇ tedavisinin temel amacı; açığa çıkmış kök yüzeylerinin, inflamasyon bulguları gözlenmeyen, minimum sondlama derinliğine ve ideal estetiğe sahip yumuşak dokuyla kapatılmasıdır. DÇ’yle ilişkili dişin yüzey durumu da değerlendirilmelidir. Çürüksüz servikal lezyonlar (ÇSL), DÇ’ye sıkça eşlik etmektedir. DÇ tedavisinde; koronale pozisyone flep (KPF) ve tünel (TUN) teknikleri, tek başına veya bağ dokusu grefti (BDG) ile kombinasyon halinde sıkça kullanılmıştır. Estetik sonuçlar açısından değerlendirildiğinde, iki teknik arasında anlamlı bir fark olmadığı, ancak gerekli durumlarda yapılan BDG ilavesinin estetiği iyileştirdiği bildirilmiştir. Keratinize doku yüksekliği (KDY) ve dişeti kalınlığı (DK) BDG ilave kararını vermede önemli parametrelerdir. KDY ≤ 1 mm ve DK < 1 mm olduğunda BDG ilavesi yapılması önerilmektedir. Yapılan çalışmalarda kök kapama miktarı açısından KPF ve TUN teknikleri arasında anlamlı bir fark bulunmazken TUN tekniğinde vertikal insizyon olmaması post-operatif morbiditeyi büyük oranda azaltmaktadır.

Anahtar Kelimeler:

Dişeti çekilmesi, Dişeti fenotipi, Keratinize dişeti, periodontal flep, tünel tekniği, Gingival phenotype, Keratinized gingiva, Periodontal flap, Tunnel technique

A Comparison of the Efficacy of Coronally Positioned Flap And Tunnel Technique in the Treatment of Gingival Recessions

The term "gingival recession" (GR) refers to the root surface opening up to the oral environment and the apical movement of the gingival marjin in relation to the cemento-enamel junction (CEJ). The main goal of GR treatment is to close exposed root surfaces with soft tissue that shows no symptoms of inflammation, requires the minumum amount of probing depth, and has the good aesthetic outcomes. The surface condition of the tooth associated with GR should also be evaluated. Non-caries cervical lesions (NCCL) commonly accompany GR. Coronally positioned flap (CPF) and tunnel (TUN) procedures have been employed frequently alone or in conjunction with connective tissue graft (CTG) in the treatment of GR. There was no discernible difference between the two methods when aesthetic outcomes have been compared, although the addition of CTG where appropriate improved the aesthetics. Gingival thickness (GT) and keratinized tissue height (KTH) are crucial factors in determining whether to add CTG.When KTH and GT are both less than 1 mm, it is recommended to add CTG. Although there was no significant difference between the CPF and TUN approaches in terms of the amount of root closure, the TUN technique's lack of a vertical incision significantly lessens post-operative morbidity.

Keywords:

gingival recession, Gingival phenotype, Keratinized gingiva, Periodontal flap, Tunnel technique,

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