Connective tissue grafting under coronal repositioning flap, for the treatment of severe multiple gingival recessions, allowed to obtain 100% effective results in a smoker patient with severe pathology.
The treatment of gingival recessions due to root hypersensitivity or esthetic reasons is one of the major concerns of patients with high levels of oral hygiene.
There are periodontal plastic surgery techniques that achieve acceptable, although not entirely predictable, results.
But now there is a periodontal plastic surgery technique that makes it possible to treat, in a single appointment, multiple advanced gingival recessions, present in all upper anterior teeth. This is based on combining a coronal repositioning flap with a subepithelial connective tissue graft.
Periodontal surgery in a real case
The image illustrates the patient treated with this new type of periodontal surgery, a 32-year-old man, smoker of five cigarettes a day and with no relevant medical history.
He presented advanced gingival recession with a poor prognosis, due to abrasion from harmful brushing, which had worn away part of the enamel – with consequent exposure of the coronal dentin. In addition, there was bone loss, especially in the area of the upper incisors.
Periodontal surgery, results
One year later, the results were completely stable, with no periodontal pockets. Thus, we found a 100% success rate, with complete coverage of the gingival recessions and a color completely mimicking the original in the previously exposed areas.
Periodontal surgery, advantages
There are many periodontal plastic surgery techniques for the coverage of multiple gingival recessions. The greatest advantage we observed in the described technique is that it was possible to cover 100% of the exposed coronal dentin, which is extremely difficult, thus avoiding the use of composite restorations to try to make up the dentin.
Another advantage is the absence of scars produced by the vertical unloading incisions. By extending the flap one tooth further distal, the use of releasers was avoided.
Therefore, the combined use of a coronal repositioning flap and a connective tissue graft allows complete coverage in cases of advanced multiple gingival recessions with poor prognosis.