Regenerative Treatment for Recession Defects Using Purified Human Platelet-Derived Growth Factor-BB, Particulate...

Recession defects are typically characterized by loss of periodontal attachment, including gingiva, periodontal ligament, alveolar bone, and cementum. Numerous techniques have been developed for treatment of these defects using soft-tissue grafting procedures with autogenous and allograft materials that generally heal with root coverage and repair of the defects. This case presentation illustrates a technique using a particulate carrier saturated with recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and coronally advanced gingival flaps to cover recession defects. Additionally, other scientific evidence from previous studies suggests that this technique may lead to periodontal regeneration, including cementum, periodontal ligament, and alveolar bone over previously exposed roots, which might be preferable to other methods that lead to periodontal repair.

This article illustrates a technique to coronally position flaps in combination with rhPDGF-BB-saturated particulate graft material. Results show significant root coverage with excellent color and texture match to adjacent tissues. Additionally, the alveolus appeared thicker than non-treated areas, suggesting appositional augmentation of the sites. Human histologic investigation of this technique in other studies confirms that periodontal regeneration can occur with this technique.

Coronally positioned flaps over rhPDGF-BB-soaked human freeze-dried bone allograft, termed "recession regeneration," can result in significant root coverage with excellent esthetics, even in demanding cases. Surgical reentry of one case shows significant regeneration of buccal alveolar bone over the previously exposed root surfaces, consistent with periodontal regeneration that is not ordinarily observed with other root coverage techniques unless biologic modifiers or cell occlusive barrier membranes are used.