Kirurške tehnike prekrivanja recesija gingive pomoću slobodnog gingivnog transplantata

master's thesis

• Title (english): Surgical techniques for treatment of gingival recessions using a free gingival graft
• Author: Marija Kelić
• Mentor: Domagoj Vražić (mentor)
• Committee member: Domagoj Vražić (predsjednik povjerenstva)
• Committee member: Marko Granić (član povjerenstva)
• Committee member: Samir Čimić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Periodontology); Zagreb
• Defense date and country: 2024-07-10, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Periodontology

Abstract

Slobodni gingivni transplantat (SGT) mekotkivni je epitelizirani presadak sluznice koji se najčešće uzima sa sluznice nepca, a osmišljen je u cilju proširenja nedostatne i/ili izgubljene pričvrsne gingive i povećanja njene debljine u prisutnosti mukogingivnih defekata. Iako tehnike slobodnog vezivnog transplantata (SVT-a) pružaju najveću predvidljivost za postizanje potpune prekrivenosti korijena zuba ili dehiscencije mekog tkiva na implantatu, tehnike slobodnog gingivnog transplantata još se uvijek smatraju tehnikama izbora za povećanje debljine mekog tkiva i keratiniziranog tkiva, odnosno sluznice na mjestima zuba, to jest dentalnih implantata. Štoviše, iako su konvencionalne metode SGT-a bile podosta nepredvidive i nepouzdanih rezultata, uvođenjem novih modificiranih metoda ne samo da se poboljšao postotak potpune prekrivenosti korijena, nego se i smanjio rizik od postoperativnih komplikacija. Naime, modificiranom metodom SGT-a dobiva se dvostruka vaskularizacija, što iz okolnog vezivnotkivnog peteljkastog režnja što iz samog slobodnog gingivnog transplantata olakšavajući time cijeljenje te pružajući rezultate gotovo jednakovrijedne dosad uvriježenom zlatnom standardu koronalno pomaknutog režnja u kombinaciji s vezivnotkivnim transplantatom. No, ne samo da su se pokazali uspješnima na prirodnim zubima, nego istraživanja pokazuju da su tehnike slobodnih gingivnih transplantata najučinkovitije u postizanju periimplantatne augmentacije mekih tkiva. Kao mana tehnika SGT-a, ali i SVT-a navodi se pacijentova nelagoda i bol uslijed dvaju operativnih polja, no u tom slučaju na raspolaganju stoje metode koronalno pomaknutog režnja u kombinaciji sa zamjenama za mekotkivne transplantate kao što je acelularni dermalni matriks.

Abstract (english)

A free gingival graft (FGG) is a soft-tissue epithelized mucosal graft that is most often harvested from the mucous membrane of the palate. It is designed to expand insufficient and lost attached gingiva and to increase its thickness in the presence of mucogingival defects. Although connective tissue graft techniques (CTG) offer the greatest predictability for achieving complete root coverage or soft tissue dehiscence on the implant, FGG techniques are still considered the techniques of choice for increasing the thickness of soft tissue and keratinized tissue, i.e., mucosa at tooth sites or dental implants. Moreover, although conventional methods of FGG were quite unpredictable and unreliable in results, the introduction of new modified methods has not only improved the percentage of complete root coverage but also reduced the risk of postoperative complications. Namely, with the modified FGG, double vascularization is obtained both from the surrounding connective tissue pedicle flap and from the FGG itself, thereby enhancing the healing process and providing results almost equivalent to the established gold standard of a coronally displaced flap in combination with a connective tissue graft. Furthermore, not only have they proven successful on natural teeth, but research shows that FGG techniques are the most effective in achieving peri-implant augmentation of soft tissues. The patient's discomfort and pain due to the two operative fields are reported as a disadvantage of the FGG and CTG technique also, but in such cases, coronally advanced flap methods are available in combination with soft tissue substitutes such as an acellular dermal matrix.

• Keywords: povlačenje gingive; transplantat tkiva; alogeni transplantat; parodontologija
• Keywords (english): gingival recession; tissue graft; allogeneic transplantation; periodontics
• Language: croatian
• URN:NBN: urn:nbn:hr:127:452526
• Study programme: Title: Integrated undergraduate and graduate university study of Dental Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-07-02 14:01:24