Keywords
recession; periodontal and peri-implant plastic surgery; connective tissue grafts.
How to Cite
Treatment of recession and mucogingival defects using connective tissue grafts on teeth and implants. (2019). Odontoestomatología, 17(26), 35-46. https://odon.edu.uy/ojs/index.php/ode/article/view/44
Abstract
Gingival recession is a common clinical finding that entails an aesthetic problem, causes hypersensitivity and hinders effective dental plaque control.
In the case of implants, recession causes aesthetic problems and its progression does not seem to be so frequent (1).
Periodontal plastic surgery procedures are indicated in these cases. These techniques must be adapted to treat peri-implant areas (1).
While the literature presents different treatment approaches, connective tissue grafts have become the gold standard as they provide a higher rate of success and predictability.
References
1-Chambrone L, Chambrone D, Shibli J. Aplicación de Cirugía Plástica Periodontal en Implantología: Cirugía Plástica Peri-implantar. En: Implantología Clínica Basada en Evidencia Científica, ABROSS, 2012, Capítulo 8, 227-243.
2- Miller PD. Regenerative and reconstructive periodontal plastic surgery: mucogingival surgery. Dental Clinic of North America, 1988; 32: 287-306.
3-Blanco J, Villaverde G, Barbosa R. Tratamiento de las recesiones gingivales con injertos de tejido conectivo. Resultados tras cinco años de evolución. Avances en Periodoncia 2000; 12(1): 35-42.
4- De Carvalho S, Ribeiro L, Coelho M. Solución estética para prótesis sobre implante. Full Dent Sci 2012; 4(13): 112-115.
5- Magne P, Magne M, Belser U. Natural and restorative oral esthetics . Part I: Rationale and basic strategies for successful esthetic rehabilitations. J. Esthetic Dent. 1993; 5: 161- 173.
6- Magne P, Magne M, Belser U. Natural and restorative oral esthetic . Part III: Fixed partial dentures . J. Esthetic Dent. 1994; 6: 15- 22.
7- Saadoun A. Periodontal implications in implant treatment planning for aesthetic results. Pract. Periodont Aesthet Dent, 1998; 10 (5): 655-664.
8-De Jesús Tavarez R, Santos A, Silva A. Remodelación del contorno gingival como forma de optimizar el resultado estético de prótesis fijas anteriores. Full Dent. Sci, 2012; 4(13): 5-15.
9- Blanco J, Ramos I. Single Implant- Supported Restorations in the Anterior Maxilla. Int. J. Periodontics Restorative Dent 2005; 25:149-155.
10-Chambrone L, Pannuti CM, Tu YK, Chambrone LA. Evidence- based periodontal plastic surgery. II. An individual data meta-analysis for evaluating factors in achieving complete root coverage. J Periodontol 2012; 83: 477-490.
11-Cooper G, Tredwin C, Cooper N. The influence of maxillary central incisor height to width ratio on perceived smile aesthetics. Br Dent J 2012; 12 (23): 589-599.
12- Wennström JL, Zucchelli G. Increased gingival dimensions. A significant factor for successful outcome of root coverage procedures? A 2-year prospective clinical study. J Clin Periodontol 1996; 23: 770-777.
13- Gonzales J, Klimek J, Meyle J. Aesthetic Periodontal Plastic Surgery: a Case Report. Perio 2004 (1) 3: 263-276.
14- Loe H, Anerud A, Boysen H. The natural history of periodontal disease in man: prevalence, severity, extent of gingival recesion. J Periodontol 1992; 63: 489-495.
15- Hall W. Present status of tissue grafting. J. Periodontol 1977; 48: 587-92.
16- Palacci P, Nowzari H. Soft tissue enhancement around dental implants. Periodontology 2000 2008;47: 113-132.
17- Olsson M, Lindhe J. Periodontal characteristics in individuals with varying forms of the upper central incisors. J Clin Periodontol 1991; 18: 78-82.
18- Palacci P, Nowzari H. Soft tissue enhancement around dental implants. Periodontology 2000 2008; 47: 113-132.
19- Shibli J, d´Avila S, Marcantonio E. Connective tissue graft to correct peri-implant soft tissue margin: A clinical report. J. Prosthet Dent 2004; 91: 119-22.
20- Shibli J, dÁvila S. Restoration of the soft tissue margin in single tooth implant in the anterior maxilla. J. Oral Implantology 2006; 32 6: 286-290.
21- Wilson T, Buser, D. Timing of Anterior Implant Placement Postextraction: Immediate Versus Early Placement. Clinical Advances in Periodontics May 2011; 1 (1): 61-76.
22- Yong-Moo L, So-Young K, Jim, K. Peri-implant soft tissue level secondary to a connective tissue graft in conjunction with immediate implant placement: a 2 year follow up report of 11 consecutive cases. Int. J Periodontics Restorative Dent 2012; 32: 213-222.
23- Covani U, Marconcini S, Galassini G. Connective tissue graft used as a biologic barrier to cover na inmediate implant. J. Periodontol 2007; 78: 1644-1649.
24- Leong D, Wang H. Árbol de decisión para injertos de tejidos blandos. Rev. Int. Odont. Rest. Period 2011; 15: 306-313.
25- Dorfman H, Kennedy J, Bird, W. Longitudinal evaluation of free autogenous gingival grafts. A four year report. J. Periodontol 1982; 53: 349-352.
26-Wennstrom J. Lack of association between width of attached gingiva and development of gingival recession. A 5 year longitudinal study. J. Clinical Period 1987; 14: 181-184
27- Miller PD. A classification of marginal tissue recession. Int J Periodontol Rest Dent 1985; 5: 9-13.
28- Cairo F, Nieri M, Cincinelli S, Mervelt J, Pagliaro U. The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: an explorative and reliability study. J Clin Periodontol 2011, 38: 661-666.
29- Salama H, Salama M, Garber D. The interproximal height of bone: a guidepost to predictable aesthetic strategies and soft tissue contours in anterior tooth replacement. Pract. Periodont Aesthetic Dent 1998; 10(9): 1131-1141.
30- Harris, R. Creeping attachment associated with the connective tissue with partial thickness double pedicle graft. J Periodontol, 1997; 68: 890-899.
31- Chambrone L, Chambrone D, Pustiglioni FE, Chambrone LA, Lima LA. The influence of tobacco smoking on the outcomes achieved by root coverage procedures: a systematic review. J Am Dent Assoc 2009; 140: 294-306
32- Berglundh T, Lindhe J, Ericsson I, Marinello CP, Liljenberg B, Thomsen P. The soft tissue barrier at implants and teeth. Clin Oral Implants Res 1991; 2: 81-90.
33- Belser U, Buser D, Hess D. Aesthetic implant restorations in partially edentulous patients- A critical appraisal. Periodontol. 2000 1998; 17: 132- 150.
34- Kazor C, Al Shammari K, Ssarment D. Implant Plastic Surgery: A review and rationale. J Oral Implantol 2004; 30(4): 240-254.
35- Ghassemian M, Nowzari H, Lajolo C. The Thickness of facial alveolar bone overlying healthy maxillary anterior teeth. J. Periodontol jun 2010; 81 (6): 885-890.
36- Chambrone LA, Villa N, Cardoso RL, Lascala NT. Aspectos histopatológicos do tratamento de retrações gengivais localizadas com retalho deslocado e associado ao ácido cítrico. Rev Peridontia 1998; 7: 61- 65.
37- Grupe H, Warren R. Repair of gingival defects by a sliding flap operation. J. Periodontol 1956; 27: 92- 99.
38- Zuchelli G, Amore C, Sforza N. Bilaminar techniques for the treatment of recession type defects. A comparative clinical study. J. Clin. Periodontol 2003; 30: 862-870.
39- Sullivan H, Alkins J. Free autogenous gingival grafts III. Utilization of grafts in the treatment of gingival recession. Periodontics 1968; 6: 152- 160.
40- Ferrao J, Kalife A, Parma A. Aumento de faja gingival insertada a través de injerto gingival libre en áreas de recesión originada por el uso de piercing: reporte de caso. Full Dent. Sci.2012; 4(13): 72-77.
41- Karring T, Lang N, Loe H. The role of gingival connective tissue in determining epithelial differentiation. J. Dent Res 1972; 51: 1303-1304.
42- Edel A. Clinical evaluation of free connective tissue grafts used to increase the width of keratinized gingiva. J. Clin. Periodontol 1974; 1: 185-196.
43- Langer B, Langer L. Subepithelial connective tissue grafts technique for root coverage. J. Periodontol 1985; 56: 715-720.
44- Raetzke P. Covering localized areas of root exposure employing the “envelope” technique. J. Periodontol 1985; 56: 397-401.
45- Allen A. Use of the supraperiosteal envelope in soft tissue grafting for root coverage. II. Clinical results. Int J Periodont Rest Dent 1994; 14: 303-315.
46- Nelson S. The subpedicle connective tissue graft. A bilaminar reconstructive procedure for the coverage of denuded root surfaces. J. Periodontol 1987; 58: 95-102
47- Wennstrom J, Zuchelli G. Increased gingival dimensions. A significant factor for successful outcome of root coverage procedures? A 2-year prospective clinical study. J. Clin Periodontol 1996; 23: 770-777.
48- Bruno J. Connective tissue graft technique assuring wide root coverage. Int J Periodontics Restorative Dent 1994; 14: 127-137.
49- Harris R. The connective tissue and partial thickness double pedicle graft: a predictable method of obtaining root coverage. J. Periodontol 1992; 63: 477-486.
50- Azzi R, Etienne D, Takei H, Fenech P. Surgical thickening of the existing gingiva and reconstruction of interdental papillae around implant-supported restorations. Int J Periodontics Restorative Dent 2002; 22: 71–77.
51- Chambrone L, Faggion CM Jr, Pannuti CM, Chambrone LA. Evidence-based periodontal plastic surgery: an assessment of quality of systematic reviews in the treatment of recession-type defects. J Clin Periodontol 2010; 37: 1110–1118.
52- Roccuzzo M, Bunino M, Needleman I, Sanz M. Periodontal plastic surgery for treatment of localized gingival reces- sions: a systematic review. J Clin Periodontol 2002;29: 178–194.
53- Harris R. The connective tissue and partial thickness doublé pedicle graft: a predictable method of obtaining root coverage. J. Periodontol 1992; 63: 477-486.
54- Reiser GM, Bruno JF, Mahan PE, Larkin LH. The subepithelial connective tissue graft palatal donor site: Anatomic considerations for surgeons. Int J Periodontics Restorative Dent 1996; 16: 130–137.
55-Chambrone L, Chambrone D, Pustiglioni FE, Chambrone LA, Lima LA. Can subepithelial connective tissue grafts be considered the gold standard procedure in the treatment of Miller Class I and II recession-type defects? J Dent 2008; 36: 659-671.
56- Harris R. Root coverage in molar recession: report of 50 consecutive cases treated with subepithelial connective tissue grafts. J. Periodontol 2003; 74: 703-708.
57- Pini Prato G, Pagliaro U, Baldi C. Coronally advanced flap procedure for root coverage. Flap with tension versus flap without tension: a randomized controlled clinical study. J. Periodontol 2000; 71: 188-201.
58- Tsourounakis I, Sweidan C, Palaiologou A. Coverage of Isolated, Severe Gingival Recession. A Modified Technique. Clinical Advances in Periodontics 2013; (10): 1-13.
59- Bohm S, Weng T, Meyle J. Connective Tissue Grafts in Periodontal Surgery. Perio 2006; 3(2): 129-137.
60- Bosco A, Días J. An Alternative Technique to the Harvesting of a Connective Tissue Graft from a Thin Palate: Enhanced Wound Healing. Int. J. Periodontics Restorative Dent 2007; 27: 133-139.
61- Harris RJ. A comparison of two techniques for obtaining a connective tissue graft from the palate. Int J Periodontics Restorative Dent 1997;17: 261-271.
62- Harris RJ. The connective tissue with partial thickness double pedicle graft: the results of 100 consecutively treated defects. J Periodontol 1994; 65: 448–461.
63- Hurzeler M, Weng D. A single incisión technique to haverst subepithelial connective tissue grafts from the palate. Int. J. Periodontics Restorative Dent 1999; 19: 279-287.
64- Khoury F, Happe A. The palatal subepithelial connective tissue flap method for soft tissue management to cover maxillary defects: A clinical report. Int. J. Oral Maxillofac Implants 2000; 15: 415-418.
65- Barbosa F, Soares D, Goncalvez E. Dimensional changes between Free Gingival Grafts Fixed with Ethyl Cyanocrylate and Silk Sutures. J. International Academy of Period 2009; 11(2): 170-176.
66- Wilderman MN, Wentz FM. Repair of a dentogingival defect with a pedicle flap. J Periodontol 1965;36: 218–231.
67- Caffesse RG, Kon S, Castelli WA, Nasjleti CE. Revascularization following the lateral sliding flap procedure. J Periodontol 1984; 55:352–358.
68- Harris RJ. Successful root coverage: a human histologic evaluation of a case. Int J Periodontics Restorative Dent 1999b; 19: 439–447.
69- Goldstein M, Boyan BD, Cochran DL, Schwartz Z. Human histology of new attachment after root coverage using subepithelial connective tissue graft. J Clin Periodontol 2001;28:657–662.
70- Pasquinelli K. Histología de la nueva inserción al utilizar un injerto autógeno de tejido blando grueso en un área de profunda recesión: Reporte de un caso. Int. J. Period Rest Dent 1995; 15:248-257.
71- Melcher AH, Accursi GE. Osteogenic capacity of periosteal and osteoperiosteal flaps elevated from the parietal bone of the rat. Arch Oral Biol 1971; 16: 573–580.
72- Melcher AH. Role of the periosteum in repair of wounds of the parietal bone of the rat. Arch Oral Biol 1969;14: 1101–1109.
73- Melcher AH. Wound healing in monkey (Macaca irus) mandible: effect of elevating periosteum on formation of subperiosteal callus. Arch Oral Biol 1971; 16: 461–464.
74- Weng D, Hürzeler MB, Quinones CR, Ohlms A, Caffesse RG. Contribution of the periosteum to bone formation in guided bone regeneration: a study in monkeys. Clin Oral Implants Res 2000; 11: 546–554.
75- Lindhe J, Karring T. Anatomy of the periodontium. En: Lindhe J, Karring T, Lang NP. Clinical Periodontology and Implant Dentistry. 3 ed. Copenhagen: Munksgaard, 1997. p19-68.
76-Bueno L, Rodriguez D. Tratamiento Interdisciplinario de Periodontitis Agresiva Localizada: Reporte de un caso. Rev Clín Periodon, Implantol Rehab Oral 2010; 3(2): 90-93.
77- Lenga Y. Connective Tissue Grafts. Ontario Dentist 2007; 84(10): 22-25.
78- Tinti C, Parma-Benfenatti S. Minimally invasive technique for gingival augmentation around dental implants. Int. J. Periodontics Restorative Dent 2012; 32: 187-193.
79-Durán J, Alarcón C, Velásquez D. Application of biological based biomaterials, bioactive molecules and tissue engineering in periodontal plastic surgery. A review. Rev. Clin. Periodoncia Implantol. Rehabil. Oral 2012; 5(3): 144-151.
2- Miller PD. Regenerative and reconstructive periodontal plastic surgery: mucogingival surgery. Dental Clinic of North America, 1988; 32: 287-306.
3-Blanco J, Villaverde G, Barbosa R. Tratamiento de las recesiones gingivales con injertos de tejido conectivo. Resultados tras cinco años de evolución. Avances en Periodoncia 2000; 12(1): 35-42.
4- De Carvalho S, Ribeiro L, Coelho M. Solución estética para prótesis sobre implante. Full Dent Sci 2012; 4(13): 112-115.
5- Magne P, Magne M, Belser U. Natural and restorative oral esthetics . Part I: Rationale and basic strategies for successful esthetic rehabilitations. J. Esthetic Dent. 1993; 5: 161- 173.
6- Magne P, Magne M, Belser U. Natural and restorative oral esthetic . Part III: Fixed partial dentures . J. Esthetic Dent. 1994; 6: 15- 22.
7- Saadoun A. Periodontal implications in implant treatment planning for aesthetic results. Pract. Periodont Aesthet Dent, 1998; 10 (5): 655-664.
8-De Jesús Tavarez R, Santos A, Silva A. Remodelación del contorno gingival como forma de optimizar el resultado estético de prótesis fijas anteriores. Full Dent. Sci, 2012; 4(13): 5-15.
9- Blanco J, Ramos I. Single Implant- Supported Restorations in the Anterior Maxilla. Int. J. Periodontics Restorative Dent 2005; 25:149-155.
10-Chambrone L, Pannuti CM, Tu YK, Chambrone LA. Evidence- based periodontal plastic surgery. II. An individual data meta-analysis for evaluating factors in achieving complete root coverage. J Periodontol 2012; 83: 477-490.
11-Cooper G, Tredwin C, Cooper N. The influence of maxillary central incisor height to width ratio on perceived smile aesthetics. Br Dent J 2012; 12 (23): 589-599.
12- Wennström JL, Zucchelli G. Increased gingival dimensions. A significant factor for successful outcome of root coverage procedures? A 2-year prospective clinical study. J Clin Periodontol 1996; 23: 770-777.
13- Gonzales J, Klimek J, Meyle J. Aesthetic Periodontal Plastic Surgery: a Case Report. Perio 2004 (1) 3: 263-276.
14- Loe H, Anerud A, Boysen H. The natural history of periodontal disease in man: prevalence, severity, extent of gingival recesion. J Periodontol 1992; 63: 489-495.
15- Hall W. Present status of tissue grafting. J. Periodontol 1977; 48: 587-92.
16- Palacci P, Nowzari H. Soft tissue enhancement around dental implants. Periodontology 2000 2008;47: 113-132.
17- Olsson M, Lindhe J. Periodontal characteristics in individuals with varying forms of the upper central incisors. J Clin Periodontol 1991; 18: 78-82.
18- Palacci P, Nowzari H. Soft tissue enhancement around dental implants. Periodontology 2000 2008; 47: 113-132.
19- Shibli J, d´Avila S, Marcantonio E. Connective tissue graft to correct peri-implant soft tissue margin: A clinical report. J. Prosthet Dent 2004; 91: 119-22.
20- Shibli J, dÁvila S. Restoration of the soft tissue margin in single tooth implant in the anterior maxilla. J. Oral Implantology 2006; 32 6: 286-290.
21- Wilson T, Buser, D. Timing of Anterior Implant Placement Postextraction: Immediate Versus Early Placement. Clinical Advances in Periodontics May 2011; 1 (1): 61-76.
22- Yong-Moo L, So-Young K, Jim, K. Peri-implant soft tissue level secondary to a connective tissue graft in conjunction with immediate implant placement: a 2 year follow up report of 11 consecutive cases. Int. J Periodontics Restorative Dent 2012; 32: 213-222.
23- Covani U, Marconcini S, Galassini G. Connective tissue graft used as a biologic barrier to cover na inmediate implant. J. Periodontol 2007; 78: 1644-1649.
24- Leong D, Wang H. Árbol de decisión para injertos de tejidos blandos. Rev. Int. Odont. Rest. Period 2011; 15: 306-313.
25- Dorfman H, Kennedy J, Bird, W. Longitudinal evaluation of free autogenous gingival grafts. A four year report. J. Periodontol 1982; 53: 349-352.
26-Wennstrom J. Lack of association between width of attached gingiva and development of gingival recession. A 5 year longitudinal study. J. Clinical Period 1987; 14: 181-184
27- Miller PD. A classification of marginal tissue recession. Int J Periodontol Rest Dent 1985; 5: 9-13.
28- Cairo F, Nieri M, Cincinelli S, Mervelt J, Pagliaro U. The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: an explorative and reliability study. J Clin Periodontol 2011, 38: 661-666.
29- Salama H, Salama M, Garber D. The interproximal height of bone: a guidepost to predictable aesthetic strategies and soft tissue contours in anterior tooth replacement. Pract. Periodont Aesthetic Dent 1998; 10(9): 1131-1141.
30- Harris, R. Creeping attachment associated with the connective tissue with partial thickness double pedicle graft. J Periodontol, 1997; 68: 890-899.
31- Chambrone L, Chambrone D, Pustiglioni FE, Chambrone LA, Lima LA. The influence of tobacco smoking on the outcomes achieved by root coverage procedures: a systematic review. J Am Dent Assoc 2009; 140: 294-306
32- Berglundh T, Lindhe J, Ericsson I, Marinello CP, Liljenberg B, Thomsen P. The soft tissue barrier at implants and teeth. Clin Oral Implants Res 1991; 2: 81-90.
33- Belser U, Buser D, Hess D. Aesthetic implant restorations in partially edentulous patients- A critical appraisal. Periodontol. 2000 1998; 17: 132- 150.
34- Kazor C, Al Shammari K, Ssarment D. Implant Plastic Surgery: A review and rationale. J Oral Implantol 2004; 30(4): 240-254.
35- Ghassemian M, Nowzari H, Lajolo C. The Thickness of facial alveolar bone overlying healthy maxillary anterior teeth. J. Periodontol jun 2010; 81 (6): 885-890.
36- Chambrone LA, Villa N, Cardoso RL, Lascala NT. Aspectos histopatológicos do tratamento de retrações gengivais localizadas com retalho deslocado e associado ao ácido cítrico. Rev Peridontia 1998; 7: 61- 65.
37- Grupe H, Warren R. Repair of gingival defects by a sliding flap operation. J. Periodontol 1956; 27: 92- 99.
38- Zuchelli G, Amore C, Sforza N. Bilaminar techniques for the treatment of recession type defects. A comparative clinical study. J. Clin. Periodontol 2003; 30: 862-870.
39- Sullivan H, Alkins J. Free autogenous gingival grafts III. Utilization of grafts in the treatment of gingival recession. Periodontics 1968; 6: 152- 160.
40- Ferrao J, Kalife A, Parma A. Aumento de faja gingival insertada a través de injerto gingival libre en áreas de recesión originada por el uso de piercing: reporte de caso. Full Dent. Sci.2012; 4(13): 72-77.
41- Karring T, Lang N, Loe H. The role of gingival connective tissue in determining epithelial differentiation. J. Dent Res 1972; 51: 1303-1304.
42- Edel A. Clinical evaluation of free connective tissue grafts used to increase the width of keratinized gingiva. J. Clin. Periodontol 1974; 1: 185-196.
43- Langer B, Langer L. Subepithelial connective tissue grafts technique for root coverage. J. Periodontol 1985; 56: 715-720.
44- Raetzke P. Covering localized areas of root exposure employing the “envelope” technique. J. Periodontol 1985; 56: 397-401.
45- Allen A. Use of the supraperiosteal envelope in soft tissue grafting for root coverage. II. Clinical results. Int J Periodont Rest Dent 1994; 14: 303-315.
46- Nelson S. The subpedicle connective tissue graft. A bilaminar reconstructive procedure for the coverage of denuded root surfaces. J. Periodontol 1987; 58: 95-102
47- Wennstrom J, Zuchelli G. Increased gingival dimensions. A significant factor for successful outcome of root coverage procedures? A 2-year prospective clinical study. J. Clin Periodontol 1996; 23: 770-777.
48- Bruno J. Connective tissue graft technique assuring wide root coverage. Int J Periodontics Restorative Dent 1994; 14: 127-137.
49- Harris R. The connective tissue and partial thickness double pedicle graft: a predictable method of obtaining root coverage. J. Periodontol 1992; 63: 477-486.
50- Azzi R, Etienne D, Takei H, Fenech P. Surgical thickening of the existing gingiva and reconstruction of interdental papillae around implant-supported restorations. Int J Periodontics Restorative Dent 2002; 22: 71–77.
51- Chambrone L, Faggion CM Jr, Pannuti CM, Chambrone LA. Evidence-based periodontal plastic surgery: an assessment of quality of systematic reviews in the treatment of recession-type defects. J Clin Periodontol 2010; 37: 1110–1118.
52- Roccuzzo M, Bunino M, Needleman I, Sanz M. Periodontal plastic surgery for treatment of localized gingival reces- sions: a systematic review. J Clin Periodontol 2002;29: 178–194.
53- Harris R. The connective tissue and partial thickness doublé pedicle graft: a predictable method of obtaining root coverage. J. Periodontol 1992; 63: 477-486.
54- Reiser GM, Bruno JF, Mahan PE, Larkin LH. The subepithelial connective tissue graft palatal donor site: Anatomic considerations for surgeons. Int J Periodontics Restorative Dent 1996; 16: 130–137.
55-Chambrone L, Chambrone D, Pustiglioni FE, Chambrone LA, Lima LA. Can subepithelial connective tissue grafts be considered the gold standard procedure in the treatment of Miller Class I and II recession-type defects? J Dent 2008; 36: 659-671.
56- Harris R. Root coverage in molar recession: report of 50 consecutive cases treated with subepithelial connective tissue grafts. J. Periodontol 2003; 74: 703-708.
57- Pini Prato G, Pagliaro U, Baldi C. Coronally advanced flap procedure for root coverage. Flap with tension versus flap without tension: a randomized controlled clinical study. J. Periodontol 2000; 71: 188-201.
58- Tsourounakis I, Sweidan C, Palaiologou A. Coverage of Isolated, Severe Gingival Recession. A Modified Technique. Clinical Advances in Periodontics 2013; (10): 1-13.
59- Bohm S, Weng T, Meyle J. Connective Tissue Grafts in Periodontal Surgery. Perio 2006; 3(2): 129-137.
60- Bosco A, Días J. An Alternative Technique to the Harvesting of a Connective Tissue Graft from a Thin Palate: Enhanced Wound Healing. Int. J. Periodontics Restorative Dent 2007; 27: 133-139.
61- Harris RJ. A comparison of two techniques for obtaining a connective tissue graft from the palate. Int J Periodontics Restorative Dent 1997;17: 261-271.
62- Harris RJ. The connective tissue with partial thickness double pedicle graft: the results of 100 consecutively treated defects. J Periodontol 1994; 65: 448–461.
63- Hurzeler M, Weng D. A single incisión technique to haverst subepithelial connective tissue grafts from the palate. Int. J. Periodontics Restorative Dent 1999; 19: 279-287.
64- Khoury F, Happe A. The palatal subepithelial connective tissue flap method for soft tissue management to cover maxillary defects: A clinical report. Int. J. Oral Maxillofac Implants 2000; 15: 415-418.
65- Barbosa F, Soares D, Goncalvez E. Dimensional changes between Free Gingival Grafts Fixed with Ethyl Cyanocrylate and Silk Sutures. J. International Academy of Period 2009; 11(2): 170-176.
66- Wilderman MN, Wentz FM. Repair of a dentogingival defect with a pedicle flap. J Periodontol 1965;36: 218–231.
67- Caffesse RG, Kon S, Castelli WA, Nasjleti CE. Revascularization following the lateral sliding flap procedure. J Periodontol 1984; 55:352–358.
68- Harris RJ. Successful root coverage: a human histologic evaluation of a case. Int J Periodontics Restorative Dent 1999b; 19: 439–447.
69- Goldstein M, Boyan BD, Cochran DL, Schwartz Z. Human histology of new attachment after root coverage using subepithelial connective tissue graft. J Clin Periodontol 2001;28:657–662.
70- Pasquinelli K. Histología de la nueva inserción al utilizar un injerto autógeno de tejido blando grueso en un área de profunda recesión: Reporte de un caso. Int. J. Period Rest Dent 1995; 15:248-257.
71- Melcher AH, Accursi GE. Osteogenic capacity of periosteal and osteoperiosteal flaps elevated from the parietal bone of the rat. Arch Oral Biol 1971; 16: 573–580.
72- Melcher AH. Role of the periosteum in repair of wounds of the parietal bone of the rat. Arch Oral Biol 1969;14: 1101–1109.
73- Melcher AH. Wound healing in monkey (Macaca irus) mandible: effect of elevating periosteum on formation of subperiosteal callus. Arch Oral Biol 1971; 16: 461–464.
74- Weng D, Hürzeler MB, Quinones CR, Ohlms A, Caffesse RG. Contribution of the periosteum to bone formation in guided bone regeneration: a study in monkeys. Clin Oral Implants Res 2000; 11: 546–554.
75- Lindhe J, Karring T. Anatomy of the periodontium. En: Lindhe J, Karring T, Lang NP. Clinical Periodontology and Implant Dentistry. 3 ed. Copenhagen: Munksgaard, 1997. p19-68.
76-Bueno L, Rodriguez D. Tratamiento Interdisciplinario de Periodontitis Agresiva Localizada: Reporte de un caso. Rev Clín Periodon, Implantol Rehab Oral 2010; 3(2): 90-93.
77- Lenga Y. Connective Tissue Grafts. Ontario Dentist 2007; 84(10): 22-25.
78- Tinti C, Parma-Benfenatti S. Minimally invasive technique for gingival augmentation around dental implants. Int. J. Periodontics Restorative Dent 2012; 32: 187-193.
79-Durán J, Alarcón C, Velásquez D. Application of biological based biomaterials, bioactive molecules and tissue engineering in periodontal plastic surgery. A review. Rev. Clin. Periodoncia Implantol. Rehabil. Oral 2012; 5(3): 144-151.