Bone-added periodontal plastic surgery: a new approach in esthetic dentistry.

Gholam Ali Gholami,Amir Reza Mehdizadeh,Hadi Gholami,Reza Amid,Navid Youssefi,Mahdi Kadkhodazadeh

doi:10.1186/s13022-015-0010-5

Gholam Ali Gholami, Amir Reza Mehdizadeh + Show 4 more

Open Access

https://doi.org/10.1186/s13022-015-0010-5

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Abstract

This article proposes a combined technique including bone grafting, connective tissue graft, and coronally advanced flap to create some space for simultaneous bone regrowth and root coverage.A 23 year-old female was referred to our private clinic with a severe class II Miller recession and lack of attached gingiva. The suggested treatment plan comprised of root coverage combined with xenograft bone particles.The grafted area healed well and full coverage was achieved at 12-month follow-up visit. Bone-added periodontal plastic surgery can be considered as a practical procedure for management of deep gingival recession without buccal bone plate.

Highlights

Marginal tissue recession is a mucogingival problem that is considered a major challenge for clinicians and patients
Several studies have confirmed thatthese recessions can be predictably covered by various surgical procedures like as pedicle flaps, subepithelial connective tissue grafts (CTG) with or without coronally positioned flap (CPF), and guided tissue regeneration (GTR), if the interdental papilla is not affected [1,2,3,4,5]
The histologic evidenceshave been mostly derived from animal studies or some case reportsconducted by the extraction of the treated teeth. It seems that CPF and CTG are associated with somedegrees of periodontal regeneration [6,7,8]

Summary

Introduction

Marginal tissue recession is a mucogingival problem that is considered a major challenge for clinicians and patients It is frequentlyassociated with esthetic concerns, fear of tooth loss, root caries, and dentin hypersensitivity. Case presentation A 23 year-old female was referred to our private clinic with a chief complaint of hypersensitivity, fear of tooth loss and gingival recession in the mandibular anterior tooth. She was in good general health and non smoker. By using no. scalpel, the Figure 2 Surgical procedure: bed preparation, root surface preparation, covering bone dehiscence with xenograft bone particles mixed with blood, stabilization of connective tissue graft over bone graft, double papilla and coronally positioned flap. The remnant particles of xenograft were still present on the root surfaces (Figure 5)

Discussion

Conclusions