A clinical comparison of two ﬂap designs for coronal advancement of the gingival margin: semilunar versus coronally advanced ﬂap
Santana RB, Mattos CML, Dibart S. A clinical comparison of two ﬂap designs for coronal advancement of the gingival margin: semilunar versus coronally advanced ﬂap. J Clin Periodontol 2010;37: 651–658. doi: 10.1111/j.1600-051X.2010.01582.x. Abstract Background: The semilunar incision was introduced in oral surgery more than a century ago. The semilunar coronally re-positioned ﬂap (SLCRF) is one of the variants of this procedure; however, no previous controlled clinical study has evaluated the SLCRF performed as originally described. The objective of the present study was to comparethe clinical outcomes of the SLCRF and coronally advanced ﬂap (CAF) procedure in the treatment of maxillary Miller class I recession (GR) defects. Materials and Methods: Twenty-two patients, with 22 contra-lateral Miller class I GR defects, were randomly assigned to CAF or SLCRF. Clinical parameters assessed included recession height, width of keratinized tissue, probing depth, vertical clinicalattachment level, visual plaque score and bleeding on probing. Clinical recordings were performed at baseline and 6 months later. Inter-measurements differences were analysed with a w2 or a paired t-test, with signiﬁcance set at ao0.05. Results: Both ﬂap designs were effective in obtaining and maintaining a coronal displacement of the gingival margin. The CAF resulted in clinical improvementssigniﬁcantly better than SLCRF for percentage of root coverage (RC), frequency of complete RC and gain in clinical attachment level. RC obtained in the immediate postsurgical period of SLCRF-treated sites was not maintained throughout the subsequent evaluations. Conclusion: RC is signiﬁcantly better with CAF compared with the original SLCRF technique in the treatment of shallow maxillary Miller class I GRdefects.
Ronaldo B. Santana1, Carolina M. L. Mattos1 and Serge Dibart2
1 Graduate Program in Dentistry, Department of Periodontology, Dental School, Federal Fluminense University, Niteroi, Rio de Janeiro, Brazil; 2Department of Periodontology, School of Dental Medicine, Boston University, Boston, MA, USA
Key words: gingiva; periodontal plastic surgery; surgical ﬂaps Accepted for publication5 April 2010
The semilunar incision was introduced in oral surgery, more than a century ago, by Partsch (1898, 1899). This incision or variants thereof have been described in mucogingival procedures for root
Conﬂict of interest and source of funding statement
The authors do not possess any ﬁnancial relationships that may pose a conﬂict of interest or potential conﬂict of interest and have nocommercial relationship to any of the products and instruments used. The present study received no funding.
r 2010 John Wiley & Sons A/S
coverage (RC) since then (Harlan 1906, Harvey 1965, Sumner 1969, Marggraf 1985, Romanos et al. 1993). More recently, Tarnow (1986) reported the semilunar coronally re-positioned ﬂap (SLCRF) technique, which is a procedure indicated for the treatment ofgingival recession in areas with minimal labial probing depth (PD) and adequate band of keratinized gingiva. It is described as a coronally advanced, tensionless and sutureless ﬂap that does not involve the adjacent papillae, thus preserving the aesthetics (Tarnow 1986). Additional advantages of the procedure,
according to the author (Tarnow 1994), include the fact that it does not shorten thevestibule and results in a perfect colour blend with adjacent tissues, with a simple, predictable and fast procedure. Occasional case reports (Pollack 1990, Torum 2003, Sorrentino & Tarnow 2009) have documented the clinical applicability of the technique, and recent studies have evaluated new modiﬁcations to the technique such as incision design and suturing (Haghighat 2006), use of microsurgical...