Innovations in the treatment of gingival recessions

Video lecture from Zucchelli's Team course

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Video lecture description:

In this video lecture, Dr Martina Stefanini discusses some of the most recent and disruptive innovations in the management of gingival recessions around teeth.

Initially, great attention is paid to the analysis of the coronal pouch flap: a technique first described in 2000 by Prof. Giovanni Zucchelli that is now considered the gold standard in the treatment of gingival recessions.

Participants will be able to observe the different stages of the evolution of this technique, starting with the addition of connective grafts, a practice that becomes necessary when there is not enough keratinized tissue to support the flap moved in a coronal direction. Attention has been paid over time not only to soft tissue but also to the management of non-carious cervical lesions at the level of bone tissue.

Dr Stefanini then goes on to illustrate the typical workflow of this technique, from the oblique serial incisions in the interproximal area to the partial thickness lifting of the surgical papillae, passing through the full thickness lifting of the central portion of the flap to the practices for detaching the alveolar mucosa from the deep planes.

After treating the soft tissues, the speaker's attention is directed to the management of the hard tissues, which involves the smoothing of the root surfaces to be performed at the same time as the disepithelialisation of the anatomical papillae.

In the second part of this presentation, Dr. Stefanini show thes V-CAF protocol, the most important modification with respect to the traditional technique, which consists in performing a flap displaced at the same time both vertically and coronally, in such a way as to allow complete root coverage even in the lower arch, an area where severe anatomical defects usually insist.

Topics covered in this video lecture:

• The fundamental role of connective grafts in the management of multiple gingival recessions
• What should be done in the presence of disadvantageous anatomical factors such as excessive buccal exposure, lack of keratinised tissue or the presence of frenulum insertions?
• When and how to modify the soft tissue phenotype around the defect site?
• How to surgically manage the lower arch where there are many anatomical obstacles?
• How to manage the poor vestibular depth with deep partial thickness incisions?

About the speaker

Lecturer at the University of Bologna since 2017, Dr Martina Stefanini conducts her research in the field of periodontology. Her research interests are particularly focused on mucogingival surgery. For years, she has been an integral part of Prof. Giovanni Zucchelli's team.