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Treatment of gingival recessions Class II Miller in lower jaw with coronary advanced flap and connective tissue graft: Case report

Balkan Journal of Dental MedicineOctober 14, 2022October 14, 2022

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Mlachkova Antoaneta, Pashova-Tasseva Zdravka

Faculty of Dental Medicine, Department of Periodontology, Sofia, Bulgaria

Summary

Background/Aim: Gingival recession is defined as apical migration if the gingival margin associated with exposure of the cement-enamel junction. The gingival recessions are major esthetic concern in patients at any age. In cases with esthetic and functional considerations mucogingival surgery is indicated. The advantages of CAF with or without CTG are making this procedure highly recommended in the esthetic zone. The results are predictable about root coverage, widening if the gingival tissues and esthetics. The aim of the recent case report is to demonstrate the successful combination of coronally advanced flap with connective tissue graft in the treatment of wide and deep gingival recessions. Case Report: Female patient seeking consultation with great concern” not to lose the lower canines”. She noticed elongation of the teeth in the recent years complained with tenderness while brushing them. The initial examination showed presence of multiple gingival recessions in the upper and the lower jaw. Full periodontal status was taken and following diagnosis was established – dental plaque induced gingivitis, class I? gingival recession in teeth #33 and #43 (Miller’s classification), RT1 by Cairo. After cause-related therapy two surgical procedures were performed in separate sessions. Both gingival recessions were surgically treated by means of CAF with CTG. Conclusions: Despite the limitating factors such as lack of keratinized tissue in the patient’s mandible that rather difficult the performance of the technique of choice, the coronally advanced flap with connective tissue graft is predictable technique for full root coverage.

Keywords: gingival recession; root coverage; connective tissue graft; coronally advanced flap

Reference

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Dai, A., Huang, J.P., Ding, P.H., Chen, L.L. (2019) Long-term stability of root coverage procedures for single gingival recessions: A systematic review and meta-analysis. J Clin Periodontol, 46: 572-585

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Garces-Mcintyre, T., Carbonell, J.M., Vallcorba, L., Santos, A., Valles, C., Nart, J. (2017) Coronal advanced flap in combination with a connective tissue graft: Is the thickness of the flap a predictor for root coverage?: A prospective clinical study. J Clin Periodontol, 44(9): 933-940

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Pini, P.G.P., Franceschi, D., Cortellini, P., Chambrone, L. (2018) Long-term evaluation (20 years) of the outcomes of subepithelial connective tissue graft plus coronally advanced flap in the treatment of maxillary single recession-type defects. J Periodontol, 89:1290-1299

Pini, P.G.P., Baldi, C., Rotundo, R., Franceschi, D., Muzzi, L. (2004) The treatment of gingival recession associated with deep corono-radicular abrasion (CEJ step): A case series. Perio, 1:57-66

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Balkan Journal of Dental Medicine, 2020, vol. 24, br. 3, str. 186-190

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