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Quintessence Publishing: Journals: IJED

 

The International Journal of Esthetic Dentistry

Edited by Alessandro Devigus, DMD

Official journal of the European Academy of Esthetic Dentistry

ISSN 1862-0612

Publication:

Fall 2012
Volume 7 , Issue 3

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Combined Orthodontic - Mucogingival Treatment of a Deep Post-orthodontic Gingival Recession

Zucchelli, Giovanni / Parenti, Serena Incerti / Ghigi, Gino / Bonetti, Giulio Alessandri

Pages: 266 - 280
PMID: 22908075

In this article, the interdisciplinary management of an isolated-type recession defect in a severely compromised mandibular incisor of a young post-orthodontic patient is described. The prognosis of root coverage surgery was very questionable and unpredictable due to the severe root malposition (III Miller class gingival recession). The treatment plan consisted of: (1) interproximal enamel reduction to gain space within the dental arch, (2) orthodontic repositioning of the root of the affected tooth within the alveolar bone and (3) root coverage mucogingival surgery. Clinical re-evaluation 7 months after fixed orthodontic treatment revealed major improvements in the root coverage prognosis due to the resolution of root malposition and de novo formation of keratinized tissue apical to the root exposure (I Miller class gingival recession). A subepithelial connective tissue graft was performed as a root coverage surgical procedure. Clinical examination 1 year after surgery revealed complete root coverage, good color blending with adjacent soft tissue and an increase in facial gingival thickness. Successful periodontal and esthetic outcomes can be accomplished after the combined orthodontic-periodontal treatment of a severely mucogingivally compromised tooth.

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