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OBJECTIVES To clinically evaluate the healing of mandibular Miller Class I and II isolated gingival recessions treated with the modified coronally advanced tunnel (MCAT) or laterally closed tunnel (LCT) combined with hyaluronic acid (HA) and subepithelial connective tissue graft (SCTG). METHOD AND MATERIALS Twelve healthy patients exhibiting one isolated mandibular Miller Class I or II (Cairo Class 1) gingival recession of a depth of ≥ 3 mm, were consecutively treated with the MCAT or LCT in conjunction with HA and SCTG. Treatment outcomes were assessed at baseline and at least 6 months postoperatively. The primary outcome variable was complete root coverage (CRC). RESULTS Postoperative pain and discomfort were low and no complications such as postoperative bleeding, allergic reactions, abscesses, or loss of SCTG occurred. After a mean follow-up of 18.9 ± 10 months, statistically significant (P < .0001) root coverage was obtained in all 12 defects. CRC was measured in six out of the 12 cases (50%), four cases showed a root coverage of over 95%, while the remaining two cases reached 80% and 85%. Mean root coverage was 96.09%. Mean keratinized tissue width increased from 1.6 ± 0.8 mm to 4.9 ± 1.3 mm (P < .0001) from baseline to follow-up, while mean probing depth showed no statistically significant changes (1.8 ± 0.9 mm vs 1.3 ± 0.5 mm). CONCLUSION Within their limits, the present results indicate that the described treatment approach may lead to predictable root coverage of isolated mandibular Miller Class I and II (Cairo Class 1) gingival recessions.

OBJECTIVE Milk is a rich source of transforming growth factor (TGF)-β which supports intestinal mucosal homeostasis of infants. Milk may also have beneficial effects on the integrity of the oral cavity, its being part of the gastrointestinal tract. However, it is unclear if milk and fermented milk products provoke a TGF-β response in oral cells. MATERIAL AND METHODS Human gingival fibroblasts were exposed to pasteurized cow milk, yoghurt, sour milk, buttermilk and whey, followed by a reverse transcriptase polymerase chain reaction of the TGF-β target genes interleukin11 (IL11), proteoglycan4 (PRG4), and NADPH oxidase 4 (NOX4). Immunoassays were performed for IL11 and TGF-β in cell culture supernatant and milk products, respectively. Signaling was investigated with the TGF-β receptor type I kinase inhibitor SB431542. RESULTS We report here that pasteurized cow milk and the aqueous fractions of yoghurt, sour milk, buttermilk and whey enhanced the expression of IL11, NOX4 and PRG4 in gingival fibroblasts. Moreover, IL11 protein levels in the respective supernatant were significantly increased. Cow milk, yoghurt, sour milk and buttermilk contain approximately 1-2 ng TGF-β1, whereas active TGF-β1 is hardly detectable in whey. SB431542 reduced the response of gingival fibroblasts to pasteurized cow milk and fermented milk products based on IL11 release into the supernatant. CONCLUSIONS These results demonstrate that gingival fibroblasts respond to pasteurized cow milk and to fermented milk products with an increased expression of TGF-β target genes.

Die Ziele der chirurgischen Kronenverlängerung sind die Verbesserung prothetischer Rekonstruktionen bei Zähnen mit wenig Zahnhartsubstanz, das Vorbeugen parodontaler Probleme und/oder die Optimierung der Ästhetik. Um ein ästhetisches Resultat speziell im Oberkiefer-Frontzahnbereich zu erzielen, sollten bei Planung und Durchführung einer Kronenverlängerung neben parodontaler und technischer Aspekte auch der Gingivaverlauf der Nachbarzähne mit berücksichtigt werden. Eine systematische Befunderhebung erleichtert die Indikationsstellung, da das Behandlungsresultat besser abgeschätzt werden kann. Dieser Beitrag stellt die chirurgische Kronenverlängerung von der Befunderhebung und Indikationsstellung bis zur Therapie und zum Resultat anhand unterschiedlicher klinischer Fälle systematisch dar und zieht Schlussfolgerungen für die Praxis., The aims of surgical crown lengthening procedures are to improve prosthetic reconstructions at teeth with limited hard tissue, to prevent periodontal problems and/or to improve esthetics. When planning and performing surgical crown lengthening, it is important to consider not only periodontal and technical aspects but also the gingival profile of the neighbouring teeth. This paper presents the systematic approach starting with the diagnosis and indication to the performed treatments and the obtained results and gives clinical recommendations., Les objectifs essentiels de l’allongement chirurgical de couronnes cliniques sont les suivants: améliorer les reconstructions prothétiques lorsque les dents ont peu de substance dure, prévenir les problèmes parodontaux et/ou optimiser l’esthétique. Afin d’obtenir un résultat harmonieux, en particulier dans la région antérieure du maxillaire supérieur, il importe de tenir compte non seulement des aspects parodontaux et techniques lors de la planification et de la réalisation de l’allongement de couronnes cliniques, mais aussi du contour de la marge gingivale des dents adjacentes. Une évaluation diagnostique systématique facilite la pose de l’indication, puisque le résultat final de traitement peut être mieux anticipé. La présente contribution décrit de façon systématique l’allongement coronaire chirurgical sur la base de différents cas cliniques, à partir de l’évaluation initiale, de la pose de l’indication et du choix des modalités thérapeutiques; elle en évalue les résultats et en tire les conclusions pour la pratique médico-dentaire.

OBJECTIVES To clinically evaluate the healing of mandibular Miller Class I and II isolated gingival recessions treated with the modified coronally advanced tunnel (MCAT) in conjunction with an enamel matrix derivative (EMD) and subepithelial connective tissue graft (SCTG). METHOD AND MATERIALS Sixteen healthy patients (13 women and 3 men) exhibiting one isolated mandibular Miller Class I and II gingival recessions of a depth of ≥ 3 mm, were consecutively treated with the MCAT in conjunction with EMD and SCTG. Treatment outcomes were assessed at baseline and at 12 months postoperatively. The primary outcome variable was complete root coverage (CRC) (eg, 100% root coverage). RESULTS Postoperative pain and discomfort were low and no complications such as postoperative bleeding, allergic reactions, abscesses, or loss of SCTG were observed. At 12 months, statistically significant (P < .0001) root coverage was obtained in all 16 defects. CRC was measured in 12 out of the 16 cases (75%) while in the remaining 4 defects root coverage amounted to 90% (in two cases) and 80% (in two cases), respectively. Mean root coverage was 96.25%. Mean keratinized tissue width increased from 1.98 ± 0.8 mm at baseline to 2.5 ± 0.9 mm (P < .0001) at 12 months, while mean probing depth did not show any statistically significant changes (ie, 1.9 ± 0.3 mm at baseline vs 1.8 ± 0.2 mm at 12 months). CONCLUSION Within their limits, the present results indicate that the described treatment approach may lead to predictable root coverage of isolated mandibular Miller Class I and II gingival recessions.