Rajiv Gandhi University of Health Sciences s177

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA

ANNEXURE – II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1 NAME AND ADDRESS OF THE DR.JASPREET KAUR, CANDIDATE POSTGRADUATE STUDENT, DEPARTMENT OF PERIODONTICS, V.S. DENTAL COLLEGE AND HOSPITAL, K. R. ROAD, V. V. PURAM, BANGALORE – 560004.

2 NAME OF THE INSTITUITION VOKKALIGARA SANGHA DENTAL COLLEGE AND HOSPITAL,BANGALORE.

3 COURSE OF STUDY AND MASTER OF DENTAL SURGERY, SUBJECT PERIODONTICS.

4 DATE OF ADMISSION TO THE 30-05-2013 COURSE

5 TITLE OF THE TOPIC COMPARATIVE ASSESSMENT OF SUB- EPITHELIAL CONNECTIVE TISSUE GRAFT AND MODIFIED BRIDGE FLAP TECHNIQUE IN THE TREATMENT OF CLASS I AND CLASS II RECESSION DEFECT- A CLINICAL STUDY.

1 6.1 NEED FOR THE STUDY

Marginal tissue recession is a condition commonly encountered in clinical practice and is characterized by the displacement of the gingival margin towards to the mucogingival junction with root surface exposure. It may occur at isolated or multiple areas of oral cavity with different extension degrees. cosmetic demands followed by root hypersensitivity, root caries or difficulty in plaque control.2

Soft tissue grafts and, in particular, the connective tissue graft provide excellent aesthetics and predictability for coverage of denuded roots. However, the availability of donor material to cover multiple recessions at once may be limited. Likewise, soft tissue grafts will need another surgical area as a donor site. This area is usually the palate that eventually increases the morbidity to the patients. Also, some patients fear the surgical use of the palate as a donor site. Therefore, these complications have led to the search for other techniques for root coverage.

The bridge flap technique was originally proposed by "Margaff"to cover gingival recession and to increase the attached gingiva in a one-step procedure. adequate attached gingiva apical to the recession. So to overcome this limitation, modified form of original bridge flap is imposed to cover the recession.

6.2 AIM OF THE STUDY:-

To assess and evaluate the outcome of modified bridge flap technique in the treatment of recession defect.

2 8. BIBILOGRAPHY

1. Saraiva JA, Campos EA, Cavassim R, De Souza Pinto SC, Fontanari LA, Pimentel

Lopes Oliveira GJ. Subepithelial connective tissue graft: a case report.

Jul-Sep;8(3):357-362.

2. Shori T, Kolte A, Kher V, Dharamthok S and Shrirao T. a comparative evaluation of

the effectiveness of subpedicle acellular dermal matrix allograft with subepithelial

connective tissue graft in the treatment of isolated marginal tissue recession: A Clinical

study. J Indian Soc Periodontol

3. Santos A, Goumenos G and Pascual A. Management of gingival recession by the the

use of an acellular dermal graft material: A case series.

1990.

4. Vijayalakshmi R, Uma S, Saravana kumar R, Ramakrishnan T, Emmadi P, Anitha V.

Double lateral sliding bridge flap for the coverage of denuded roots: Two case reports.

PERIO-Periodont Pract Today

5. Sandro Bittencourt, Erica Del Peloso Ribeiro, Enilson A. Sallum, Antonio W. Sallum,

Francisco H. Nociti Jr. and Marcio Zaffalon Casati. Comparative 6 month clinical

study of a semilunar coronally positioned flap and subepithelial connective tissue graft

3 for the treatment of gingival recession

6. GuptaV, Bains VK, MohanR, Bains R. Bridge flap technique as a single step solution

to mucogimgival problems: A case series .

7. Verma PK, Srivatava R, Chaturvedi TP, Gupta KK. Root coverage with bridge flap

Indian Soc Periodontol

8. Cario F, Cortellini P, Tonetti M, Nieri M, Mervelt J, Cincinelli S

Coronally advanced flap with or without connective tissue graft for the treatment of

single maxillary gingival recession with loss of inter-dental attachment. A randomized

controlled clinical trial.

9. Marggraf E. A direct technique with a double lateral bridging flap for coverage of

denuded root surface and gingival extension. clinical evaluation after 2 years.

Periodontol

4 5 6 ANNEXURES

V. S. DENTAL COLLEGE AND HOSPITAL, BANGALORE.

DEPARTMENT OF PERIODONTOLOGY

CONSENT FORM

Study title: -“COMPARATIVE ASSESSMENT OF SUB-EPITHELIAL CONNECTIVE TISSUE GRAFT AND MODIFIED BRIDGE FLAP TECHNIQUE IN THE TREATMENT OF CLASS I AND CLASS II RECESSION DEFECT”- A CLINICAL STUDY.

Conducted by: Jaspreet Kaur Post Graduate Student

I……………………………………. son/daughter/wife of…………………………………… aged…………….. resident of…………………………………………………… do hereby give consent to perform the clinical examinations and recommended minor surgical procedures or treatment. The procedure has been explained to me in my own language. Any complications arising with it, if any, I agree that no responsibility will be attached to the surgeon or hospital staff.

Signature of Patient/Parent:

Signature of Witness:

Signature of Researcher:

Place:

Date:

7 «.J¸ï.zÀAvÀ ªÉÊzÀåQÃAiÀÄ PÁ¯ÉÃdÄ ªÀÄvÀÄÛ D¸ÀàvÉæ ¨ÉAUÀ¼ÀÆgÀÄ

M¥ÀàAzÀzÀ Cfð ¥ÀvÀæ

“ªÀUÀð-1 ªÀÄvÀÄÛ ªÀUÀð-2 C¥À¸ÀgÀt £ÀÆå£ÀvÉAiÀÄ aQvÉìAiÀÄ°è ¸À¨ï-J¦yÃ°AiÀÄ¯ï ¸ÀA§A¢üvÀ CAUÁA±ÀUÀ¼À (ssubepithelial connective tissue) ªÀÄvÀÄÛ §zÀ¯ÁzÀ ¸ÉÃvÀÄªÉAiÀÄAvÀ PÀªÀZÀzÀ (modified bridge flap technique) ¥ÀæQæAiÉÄAiÀÄ vÀÄ®£ÁvÀäPÀ ªÀiË®åªÀiÁ¥À£”À: MAzÀÄ ªÉÊzÀåQÃAiÀÄ CzsÀåAiÀÄ£À.

d¹àçÃvï PËgï

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ನನಾನನ…………………………………………………ಮಗ/ಮಗಳಳ/ಹಹಹೆಂಡತ……………………………………………..

ವಯಸನಸ……………………………… ವನಾಸಿಸನತತ್ತಿರನವ ………………………………………………….. ನನನ್ನ ಚಿಕಿತಹಸ ಮತನತ್ತಿ ಹನಾಗನ

ಶಸಸ್ತ್ರಚಿಕಿತನಾಸ ವಿಧನಾನಕಹಕ(ಚಿಕಕ) ಸಹಕನಾರ ಮತನತ್ತಿ ಸಮಮ್ಮತಯನನನ್ನ ಕಹಕೊಡಲನ ಒಪಪ್ಪಿದಹದದ್ದೇನಹ. ಸಲಹಹ ನದ್ದೇಡಿರನವ

ವಿಧನಾನಗಳನನನ್ನ ಅಥವನಾ ಚಿಕಿತಹಸಯ ಬಗಹಗ್ಗೆ ಸಹೆಂಪಪೂರರ್ಣ ಮನಾಹಿತಯನನನ್ನ ನನನ್ನ ಭನಾಷಹಯಲಲ್ಲಿಕಹಕೊಡಲನಾಗಿದಹ.ಇದರಹೆಂದ,

ನನಗಹ ಯನಾವವುದನಾದರನ ಹನಾನ ಅಥವನಾ ತಹಕೊಹೆಂದರಹಗಳಳಹೆಂಟನಾದರಹ, ಶಸಸ್ತ್ರಚಿಕಿತಹಸ ಮನಾಡನವವರಗಹ ಅದನ

ಸಹೆಂಬಹೆಂಧವಿರನವವುದಿಲಲ್ಲಿ.

ಸನಾಕ್ಷಿದನಾರನ ಸಹಿ

ಸಸ್ಥಳ : ದಿನನಾಹೆಂಕ: ರಹಕೊದ್ದೇಗಿಯ ಸಹಿ

ವಹವೈದದ್ಯರ ಸಹಿ CASE RECORD PROFORMA

8 Name of the patient: Date:

Age / Sex: O.P. No. :

Address & Ph. No.: Occupation:

Chief Complaint:

History of Present Illness:

Past Dental History:

Medical History:

Family History:

TOOTH NO. :-

9 Recession width:

Recession height:

Width of attached gingiva:

10 V.S. DENTAL COLLEGE & HOSPITAL, BANGALORE.

DEPARTMENT OF PERIODONTOLOGY.

Name of the patient: Date:

Age / Sex: O.P. No. :

Address & Ph. No.: Occupation:

Baseline 6 Months

Recession width(RW)

Recession height(RH)

Width of AG(GW)