Recession Defects

Treatment of recession defects continues to be a growing focus of periodontal care. Todays patients want more than just relief from root sensitivity - they want superior esthetics.

As an adjunct to coronally advanced flap surgery, Straumann® Emdogain offers a biology-based solution that restores esthetics and provides potential for re-growth of lost periodontal tissues.

Treatment of Recession Defects

Straumann<sup>®</sup> Emdogain - Recession Scale

Anesthetize the operative area.

Scale and plane the exposed root surface to remove plaque, calculus, root surface irregularities and, if judged appropriate, to reduce prominence.

Extensive root planing is recommended when (i) root caries lesion has been diagnosed or (ii) when a reduced root prominence has been judged beneficial for tissue regeneration. The presence of a restoration does not preclude the possibility for root coverage, but the restoration should ideally be removed prior to covering the root with the soft tissue flap.
Straumann<sup>®</sup> Emdogain - Recession Incision

A sulcular incision is made at the site of the recession. Extend the incision horizontally into the adjacent interdental areas a couple of millimeters coronal to the level of the soft tissue margin of the recession.

Make two vertical divergent releasing incisions starting at the lateral endpoints of the horizontal incisions and directed apically into the lining mucosa.
Straumann<sup>®</sup> Emdogain - Recession Flap 1

Raise a full-thickness flap until the mucogingival junction is passed or approximately 3mm apical to the bone dehiscence. Make a horizontal cut through the periosteum.
Straumann<sup>®</sup> Emdogain - Recession Flap 2

Continue to raise a split-thickness flap by blunt dissection. The blunt dissection is extended apically and laterally to such an extent that coronal positioning of the flap is facilitated.
Straumann<sup>®</sup> Emdogain - Recession Flap 3

 De-epithelialize the buccal aspect of the interdental papillas to create a connective tissue bed for suturing the coronally advanced flap.
Straumann<sup>®</sup> Emdogain - Recession PrefGel™

Remove "smear layer" by conditioning the root surface with Straumann® PrefGel for two minutes. Rinse thoroughly with saline solution. Avoid contaminating the cleaned and conditioned root surface with blood or saliva after the final rinse.
Straumann<sup>®</sup> Emdogain - Recession Application

Immediately apply Straumann® Emdogain to fully cover the exposed and conditioned root surface.
Straumann<sup>®</sup> Emdogain - Recession Suture

Advance the flap coronally and secure it at the level of the CEJ by suturing the flap into the recipient bed, i.e. the de-epithelialized papillae. Also close the vertical incisions with lateral sutures.

Use suture materials for extended and stable closure. No pressure should be applied to the flap after suturing. The use of a periodontal dressing is optional. If in the judgment of the clinician it is necessary to improve wound protection in the surgical area during the initial healing phase, one of several commercially available periodontal dressings may be applied.