MODIFIED CORONALLY ADVANCED FLAP APPROACH WITH ISTHMUS DEEPITHELIALIZATION FOR THE TREATMENT OF MULTIPLE RECESSION DEFECTS IN CASES WITH INTERDENTAL TISSUE LOSS

Abstract

PURPOSE: This presentation demonstrates a modified surgical approach for multiple gingival recessions in sites with interdental papillae loss and a newly developed method for prediction of the possible root coverage MATERIAL/METHODS: A 41 years old patient with a diagnosis of Periodontitis II Stage, Grade A. The main complaint was the hypersensitivity, which has even increased after the initial periodontal therapy and his chief request was to cover the exposed root surfaces. In order to achieve a harmonic gingival display and good esthetics, root coverage on all teeth from 13 to 25 was required. The surgical planning revealed a decreased height of interdental papillae. The analysis of the maximum achievable root coverage demonstrated that the intended line of coverage could not be reached with the available root coverage procedures. A new surgical technique, together with a new measuring protocol for accurate prediction of the achievable level of root coverage were developed. RESULT: One year after treatment, a consistent root coverage was observed with an established proper gingival profile The achieved line of the gingival margin completely coincided with the presurgical planning. The patient was fully satisfied with the esthetic result and the reduction of the hypersensitivity. CONCLUSION: In the limitation of the presented case, the developed new method for prediction of the root coverage and modified surgical approach for cases with interdental papillae loss and preserved isthmus provided a predictable increase of the achievable root coverage. Further research is required to study the efficiency of this newly developed surgical approach.