The effectiveness of allogeneic dura mater for the preventive surgical treatment of single and multiple gingival recessions before orthodontic treatment with fixed orthodontic appliances: a clinical research

Abstract

Relevance. Gingival recessions are frequent during or after orthodontic treatment with fixed appliances (65.0-86.7%). They are usually observed in anterior teeth, especially in teeth bodily movements along an archwire outside the bone or in buccal/ labial tipping more than five degrees along the axis (35%). Pre-existing recessions worsen during orthodontic treatment with fixed appliances and up to 5 years after the treatment (47%). The treatment of recessions during or after the orthodontic treatment is not strategically reasonable: the relapse rate is high, and the treatment implies large-scale surgical interventions, including osteoplastic surgery; it is more often performed with free gingival de-epithelized graft after the treatment, which has many comparative disadvantages. Purpose – the study aimed to evaluate the effectiveness of a graft material (allogeneic dura mater) to eliminate gingival recessions before orthodontic treatment or to create/ thicken the volume of the gum buccally/ labially to prevent rec eding gum during or after orthodontic treatment.Materials and methods. The paper presents and closely analyzes preventive surgical treatment in a patient with pretreatment gingival recessions.Results. In all cases, using the dura mater demonstrates a positive clinical result by all parameters of the gingival recession assessment. The percentage of root coverage is 100% in all teeth.Conclusion. Preventive surgical treatment is reasonable in all cases as it eliminates the need for repeated interventions, excludes the onset of gingival recessions during or after orthodontic treatment, as well as the reappearance of gingival recessions. Dura mater is effective and safe in all cases; the response to surgery is normal, dura mater allows avoiding a second surgical field. We recommend including it in the standard protocol of orthodonti c treatment.