PDF(Pubmed)
Abstract：
OBJECTIVE: The goal of this article was to introduce a new root coverage (RC) technique, the mixed-thickness tunnel access (MiTT) technique, which approaches a full-split design and intends to augment soft tissues coronal to the gingival margin. It was shown step-by-step, and the results were presented in a case series.
METHODS: Healthy individuals (non-diabetics) and non-smokers with gingival recession (GR) type 1 or 2 (RT1 or RT2) were included. After evaluation, prophylaxis was performed 14 days before the surgical procedure. During the surgical appointment, one or two vertical incision(s) on the mucosa (around 1-2 mm apical to the MGJ), lateral to the papilla base, was/were performed after anesthesia. Initially, there was a partial incision to detach the mucosa of the muscles (split design). It was permitted (but not mandatory) to perform intrasulcular incisions. Through the vertical incision, internally, subperiosteal access from the MGJ toward the gingival margin (coronally) was performed to create a full-thickness tunnel. Then, communication from the vertical incision with the gingival sulcus and the papilla base occurred, keeping the papilla tip intact. A connective tissue graft was harvested and inserted through the linear incision or intrasulcularly. There were interrupted sutures. An adjunctive material may be applied (e.g., Endogain). The root coverage was measured using a periodontal probe and considered fully covered when the gingival margin was 1 mm coronal to the cementum-enamel junction (CEJ).
RESULTS: Nine healthy individuals (seven females and two males) aged 19 and 43 were enrolled. They were treated following the MiTT steps. Four cases had a single GR; two patients had two teeth involved; and three others had three or four GR. There were seven cases of RT1 and two RT2. All RT1 cases achieved 100% RC, while the mean RC obtained for RT2 was around 80%.
CONCLUSIONS: The MiTT technique can be considered a more straightforward approach for minimally invasive surgical techniques, which is a feasible option to treat RC with a high success rate, predictability, and esthetic preservation. Therefore, there is a technical sensitivity to performing the full-split design procedure.
METHODS: Healthy individuals (non-diabetics) and non-smokers with gingival recession (GR) type 1 or 2 (RT1 or RT2) were included. After evaluation, prophylaxis was performed 14 days before the surgical procedure. During the surgical appointment, one or two vertical incision(s) on the mucosa (around 1-2 mm apical to the MGJ), lateral to the papilla base, was/were performed after anesthesia. Initially, there was a partial incision to detach the mucosa of the muscles (split design). It was permitted (but not mandatory) to perform intrasulcular incisions. Through the vertical incision, internally, subperiosteal access from the MGJ toward the gingival margin (coronally) was performed to create a full-thickness tunnel. Then, communication from the vertical incision with the gingival sulcus and the papilla base occurred, keeping the papilla tip intact. A connective tissue graft was harvested and inserted through the linear incision or intrasulcularly. There were interrupted sutures. An adjunctive material may be applied (e.g., Endogain). The root coverage was measured using a periodontal probe and considered fully covered when the gingival margin was 1 mm coronal to the cementum-enamel junction (CEJ).
RESULTS: Nine healthy individuals (seven females and two males) aged 19 and 43 were enrolled. They were treated following the MiTT steps. Four cases had a single GR; two patients had two teeth involved; and three others had three or four GR. There were seven cases of RT1 and two RT2. All RT1 cases achieved 100% RC, while the mean RC obtained for RT2 was around 80%.
CONCLUSIONS: The MiTT technique can be considered a more straightforward approach for minimally invasive surgical techniques, which is a feasible option to treat RC with a high success rate, predictability, and esthetic preservation. Therefore, there is a technical sensitivity to performing the full-split design procedure.
摘要：
目的：本文的目的是引入一种新的根覆盖（RC）技术，混合厚度隧道接入(MiTT)技术，接近全分裂设计，并打算增加软组织冠状牙龈边缘。它是一步一步地展示的，结果在案例系列中呈现。
方法：包括健康个体（非糖尿病患者）和非吸烟者的牙龈衰退（GR）1型或2型（RT1或RT2）。经过评估,在手术前14天进行预防.在手术预约期间，粘膜上的一个或两个垂直切口（MGJ顶端约1-2mm），侧向乳头基部，在麻醉后进行。最初，有一个部分切口来分离肌肉的粘膜（分裂设计）。允许（但不是强制性的）进行静脉内切口。通过垂直切口，内部,从MGJ向牙龈边缘(冠状)进入骨膜下通道以形成全厚度通道.然后，垂直切口与龈沟和乳头基部发生沟通，保持乳头尖端完整。收获结缔组织移植物并通过线性切口或血管内插入。缝线中断了。可以应用辅助材料(例如，Endogain）。使用牙周探针测量根部覆盖率，当牙龈边缘与牙骨质-釉质交界处（CEJ）冠状1mm时，认为根部覆盖率已完全覆盖。
结果：纳入9名健康个体（7名女性和2名男性），年龄分别为19岁和43岁。在MiTT步骤之后对它们进行处理。4例具有单个GR；两名患者涉及两颗牙齿；另外三名有三个或四个GR。有7例RT1和2例RT2。所有RT1病例达到100%RC,而RT2获得的平均RC约为80%。
结论：MiTT技术可以被认为是一种更直接的微创手术技术，这是一个可行的选择，治疗RC成功率高，可预测性,和审美保存。因此,执行全拆分设计程序具有技术敏感性。
方法：包括健康个体（非糖尿病患者）和非吸烟者的牙龈衰退（GR）1型或2型（RT1或RT2）。经过评估,在手术前14天进行预防.在手术预约期间，粘膜上的一个或两个垂直切口（MGJ顶端约1-2mm），侧向乳头基部，在麻醉后进行。最初，有一个部分切口来分离肌肉的粘膜（分裂设计）。允许（但不是强制性的）进行静脉内切口。通过垂直切口，内部,从MGJ向牙龈边缘(冠状)进入骨膜下通道以形成全厚度通道.然后，垂直切口与龈沟和乳头基部发生沟通，保持乳头尖端完整。收获结缔组织移植物并通过线性切口或血管内插入。缝线中断了。可以应用辅助材料(例如，Endogain）。使用牙周探针测量根部覆盖率，当牙龈边缘与牙骨质-釉质交界处（CEJ）冠状1mm时，认为根部覆盖率已完全覆盖。
结果：纳入9名健康个体（7名女性和2名男性），年龄分别为19岁和43岁。在MiTT步骤之后对它们进行处理。4例具有单个GR；两名患者涉及两颗牙齿；另外三名有三个或四个GR。有7例RT1和2例RT2。所有RT1病例达到100%RC,而RT2获得的平均RC约为80%。
结论：MiTT技术可以被认为是一种更直接的微创手术技术，这是一个可行的选择，治疗RC成功率高，可预测性,和审美保存。因此,执行全拆分设计程序具有技术敏感性。
