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Dental Bites Newsletter
November 01, 2024
Bite into the latest news in oral health.
Successful use of Oracell® to Treat Gingival Recession (GR) 1
Twenty patients (mean age: 33.4 years) underwent treatment for gingival recession Type 1 (RT1) via the modified coronally advanced tunnel technique (MTUN) combined with an acellular dermal matrix (ADM), Oracell (LifeNet Health). Clinical measurements were assessed digitally at Baseline, six weeks, and three- and six months for the following:
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Recession depth (RD)
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Recession area (RA)
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Keratinized tissue width (KTW)
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Probing depth (PD)
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Clinical attachment level (CAL)
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Marginal gingival thickness (MGT) change
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Mucosal volume (MV) change
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Root coverage (RC)
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Complete root coverage (CRC)
Only MV and MGT were measured perioperatively.
From Baseline to six months, improvements were observed in all clinical endpoints. The mean RD, RA, CAL, MGT (1.5 mm), MGT (3 mm), and MV reduction at six months was –1.92 ± 0.70 mm, –5.44 ± 3.11 mm, –1.51 ± 0.88 mm, –1.08 ± 0.55 mm, –1.26 ± 0.74 mm, and –0.79 ± 1.09 mm, respectively (p<0.001). The mean increase at six months for KTW and PD was 0.45 ± 0.88 mm and 0.40 ± 0.54 mm, respectively (p<0.001). Mean RC was 93% and CRC was found on 72.3% of the sites at six months. Predictors of CRC were gingival margin positioned ≥0.5 mm coronal to the cementoenamel junction (GM-CEJ) and perioperative MGT gain.
Specifically, each additional mm of perioperative MGT gain (measured at 1.5 and 3 mm apical to the GM) resulted in a four-fold increase in the probability of achieving CRC at six months. Following surgery, MGT significantly decreased over time due to shrinkage of the tissue and resorption of Oracell, indicative of adequate healing. Eighteen out of 20 patients had favorable results without postoperative complications. Of those two patients who experienced complications, one achieved CRC while the other achieved 71.24% and 62.26% of RC at the treated sites. Collectively, these results supported the authors’ conclusion that the use of MTUN + Oracell was successful in treating multiple mandibular and maxillary gingival recessions.
Oracell and the modified coronally advanced tunnel technique (MTUN) resulted in 93% root coverage (RC) and 72.3% complete root coverage (CRC)
“MTUN + [Oracell] is a reliable and predictable technique for root coverage of single and multiple GRs in both the maxilla and mandible,” achieving mean RC and CRC rates of 93% and 72.3%, respectively, at six months, comparable to that reported in the literature.1
Perioperative marginal gingival thickness (MGT) gain was a significant predictor of CRC at six months
Each additional mm of perioperative MGT (measured at 1.5 and 3 mm apical to the gingival margin) resulted in a four-fold increase in the probability of achieving CRC. Following surgery, MGT significantly reduced over time due to shrinkage of the tissue and the resorption of Oracell, indicative of an adequate healing process.
90% success rate
Complication rates were low: Only two out of 20 patients experienced postoperative complications, not attributed to Oracell, using this technique that resulted in “minimal surgical trauma–particularly when combined with [Oracell].”
Reference
1. Blasi G, Vilarrasa J, Abrahamian L, Monje A, Nart J, Pons R. Influence of immediate postoperative gingival thickness and gingival margin position on the outcomes of root coverage therapy: A 6-month prospective case series study using 3D digital measuring methods. J Esthet Restor Dent. 2023;1-11. doi:10.1111/jerd.13042.
Dental News
The European Federation of Periodontology reports global cost of gingivitis, caries, tooth loss.
Disparities in oral health have impacted countries with lower socio-economic status, resulting in rising oral diseases, malnutrition, and limited preventative care. Addressing the factors contributing to these disparities is key to ensuring everyone has access to essential oral health care, regardless of social status.
A white paper commissioned by the European Federation of Periodontology (EFP), titled “Time to put your money where your mouth is: addressing inequalities in oral health,” reported that 4.9% of global healthcare expenditure goes towards treating preventable oral health conditions such as gingivitis, caries, and tooth loss. The Economist Impact report found that a preventive approach that addresses caries progression in economically challenged groups would bring substantial savings in long-term treatment costs.
The white paper underscores the disproportionate impact of oral disease on lower socioeconomic groups, linking poor oral health to broader well-being and economic challenges. It advocates for preventive care, better access to dental services, and the integration of oral health into national health policies. The report calls for a shift from a restorative to a preventive model of dental care, emphasizing the importance of early intervention, education, and public-private partnerships to address oral health disparities and improve overall health outcomes.
LifeNet Health News
LifeNet Health has partnered with the American Academy of Periodontology (AAP) to host two educational modules on their Education Access Site. The modules can be integrated into program curriculum or used as a study club, and are available for predoctoral, postdoctoral, and practice management studies.
Bone Regeneration and Bone Physiology in Periodontics
Brad McAllister, DDS, PhD
Dr. McAllister reviews bone grafting in periodontics with a brief introduction to various bone graft materials used from dental implant placement.
Tissue Transplantation: Ensuring Safety for Dental Allografts
Elena Gianulis, PhD
Dr. Gianulis reviews the goals and importance of allograft tissue safety, and the donor tissue donation process, and answers common questions about allograft safety.
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