Abstract
Background: In the United States, orthodontic therapy has become a common phase in people’s lives. Patients seek treatment for esthetic and functional reasons. As with most treatment modalities, it has its own risks and benefits. Anatomic variations can predispose certain patients to problems. Presenting with a thin gingival tissue biotype, where arch expansion is needed, can predispose the patients for mucogingival defects and bony dehiscences. The purpose of this case report is to present a surgical approach to augment both hard and soft tissue, post orthodontic treatment to manage the resulting dehiscence and prevent potential future recession. Methods: An eighteen year old patient presented to the University of Illinois, College of Dentistry six years after completion of active orthodontics. The lower anterior segment was characterized by a thin gingival tissue biotype, prominent roots and a minimal zone of keratinized tissue. A surgical procedure was performed by placing an allogenic bone graft with subepithelial connective tissue graft and enamel matrix protein. Results: Surgical procedure augmenting hard and soft tissue was completed with uneventful post-operative healing. The goals of increased tissue thickness and prevention of recession were accomplished through this technique and the results were stable after a one year follow up.
Highlights
Orthodontic Therapy has become a common phase of many dental patients’ life at least in the US
According to an NHANES III survey, the Index of Treatment Need to the reveals that 57% to 59% of each racial/ethnic group has at least some degree of orthodontic treatment need
As with most treatment and preventive modalities, orthodontic treatment is associated with potential risks and side effects
Summary
Orthodontic Therapy has become a common phase of many dental patients’ life at least in the US. Given the fact that the patient has a thin gingival biotype, with minimal amount of keratinized and attached gingiva in the mandibular anterior region at a young age with inconsistent plaque control, it was decided to perform a grafting procedure with the purpose of augmenting both hard and soft tissue using an autogenous subepithelial connective tissue graft procedure and an allogenic bone graft and biological material to enhance healing. This procedure would produce a thicker band of attached gingiva, increase the thickness of the labial plate which would allow for long-term stability and health of the periodontium. The findings and recommendations were explained to the patient and the patient consented to undergo the surgical procedure
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