Pinhole Surgical Technique: A Different Approach to Root Coverage

Pinhole Surgical Technique: A Different Approach to Root Coverage

Learning Objectives:
• Differentiate between initiating and modifying factors of periodontal diseases.
• Discuss gingival recession and its etiology
• Compare between Pinhole surgical technique (PST) and conventional methods of root coverage.
• List indications and limitations of PST
• Explain advantages of PST

Abstract:

Dental plaque biofilm and calculus are the main initiating factors of periodontal diseases. Gingival recession is considered one of the most serious signs of periodontitis which negatively affected the quality of life of an individual by compromising the aesthetics. Many conventional types of periodontal surgeries had been used to manage this problem but it has a number of limitations and disadvantages. In 2012 a new pinhole surgical technique (PST) has been introduced by Dr. Jhon C. Chao based on the understanding of the nature of the histology of gingival tissues.

Introduction:

Periodontitis is a multifactorial disease resulting in inflammation within supporting tissues of the teeth, progressive attachment loss and bone loss. In addition, it is characterized by Periodontal Pocket formation, Furcation involvement, mobility, change in tooth position with Food impaction and halitosis (90% intra oral causes), Gingival recession (GR) and eventually ended by tooth loss if not treated properly. Gingival recession is defined as an apical displacement of the gingival margin from the Cemento-Enamel Junction which could be hidden or visible recession. Receding gums can be the result of: Periodontal disease, Clenching, grinding, aggressive brushing habit, tobacco use, the natural aging process, anatomical/Genetics, hormones and iatrogenic factors. Most patients with receding gums do not realize that it is occurring because it happens gradually. The prevalence varied from 50-90% among populations. 88% of people over 65 years of age experience some form of gingival recession in al least one tooth. Traditionally, patients who suffered from advanced gum recession had only one treatment option: surgical soft tissue grafting. A Pinhole Surgical Technique® was published in the October 2012 minimally invasive procedure. The results of this study were as successful as traditional gum grafting procedures which require cutting and sutures.