Preorthodontic Management of Gingival Recession using Epithelial Embossed Connective Tissue Graft: A Case Report with Two years Follow-up

Abstract

Gingival recession is an aesthetic and functional problem requiring surgical management in most cases. Adequate gingival health is a prerequisite to maintain plaque control during orthodontic treatment. This case report described management of gingival recession before orthodontic treatment using a novel surgical method. Here, authors presented a case of 27-year-old female patient reported to the Department of Periodontics for management of gingival recession in the lower front tooth region. The patient was diagnosed with Miller’s Class II gingival recession on mandibular right central incisor. Vestibular depth and width of attached gingiva was found to be inadequate at the recession site. The case was managed with epithelial embossed connective graft. The recipient site was prepared using envelope technique and internal vestibular deepening was performed before placing the graft. Complete root coverage, adequate vestibular depth and width of attached gingiva were obtained postoperatively. Due to high aesthetic demand of the patient, orthodontic therapy was instituted six months following root coverage and patient could maintain good oral hygiene during orthodontic treatment. Results of surgical treatment were maintained till two years follow-up. Careful selection of surgical technique could enhance thickness and width of attached gingiva and retain vestibular depth at the recipient site. Successful case management enabled the patient to maintain gingival health during orthodontic treatment.