Injerto de tejido conectivo en combinación con la técnica de colgajo lateralmente cerrado para el tratamiento de recesiones gingivales anteroinferiores: resultado clínico y revisión sistemática comparativaTrabajo ganador del Premio Científico Anual “Dr. D Francisco Javier Alández Chamorro” 2023

Resum

Objective: To evaluate the clinical efficacy of the laterally closed tunnel technique with connective tissue grafting in single gingival recessions in the anteroinferior area, using a series of six cases. Another objective was to carry out a review to compare the efficacy of the laterally closed tunnel technique versus the coronal advancement flap technique with connective tissue graft. aterial and methods: Six patients with anteroinferior gingival recessions were treated using the laterally closed tunnel technique. Different periodontal clinical variables were collected, especially the depth of recession to calculate the percentage of root coverage of this technique. On the other hand, a literature review was carried out based on the following PICO question: P (patients with single gingival recessions in mandibular anterior teeth), I (laterally closed tunnel technique with connective tissue graft), C (coronal advancement flap technique), O (analysing probing depth, recession depth, clinical attachment level, width of keratinised tissue, gingival thickness, average root coverage and complete root coverage). Results: In the case series a mean root coverage of 96. 67% ± 8.17 % was obtained, this result being statistically significant. The same was true for the reduction in recession depth (p=0.001), clinical attachment level (p=0.003) and the gain in keratinised tissue width (p=0.001) and gingival thickness (p<0.001). The reduction in probing depth was not significant. In terms of the systematic review, it was found that probing depth was greater in the coronal advancement flap technique, while better gains in keratinised tissue width were obtained with the laterally closed tunnel technique. Conclusions: The laterally closed tunnel technique with connective tissue grafting achieves predictable and statistically significant results, except for the reduction of probing depth. Furthermore, it was concluded that the clinical efficacy of both techniques is very similar, achieving greater gain in width of keratinised tissue with the laterally closed tunnel technique, although a greater number of studies of this technique would be desirable in order to evaluate its long-term clinical results.