REDUCTION OF MOBILITY OF PERIODONTALY AFFECTED TEETH AFTER GINGIVAL AUGMENTATION WITH AN AUTOGENOUS GINGIVAL GRAFT (Case Report).

Abstract

INTRODUCTION: The most severe complication of advanced periodontal lesions is the loss of teeth due to terminal attachment loss and high grade mobility. The goals of the treatment are the improving the plaque control stabilizing of the mobile teeth and arresting of the progression of gingival recession achieving gingival augmentation with adequate vestibulum depth. The autogenous graft is considered to be the most efficient approach where a significant increase of the attached gingiva is needed. OBJECTIVE: This presentation demonstrates the capacity of the autogenous gingival graft approach to reduce the high grade tooth mobility and to augment keratinized gingiva. METHODS: V.T. (46) with moderate generalized periodontitis. The examination reveals thin periodontal biotype, Class IV recessions on 31,41 with III grade mobility and terminal attachment loss, narrow vestibulum and lack of attached gingiva. An autogenous graft technique was selected to achieve simultaneous gingival augmentation and correction of vestibulum depth. RESULTS: A significant and stable increase of the attached gingiva is observed which led to better access for oral hygiene thus creating better conditions for successful long-term outcome. The root coverage was more that 40% and the tooth mobility was decreased to grade I. CONCLUSION: In the limitations of the presented case the free autogenous graft technique seems an appropriate approach in cases with deep Class IV recessions and high grade toot mobility in mandibular frontal area creating proper conditions for effective oral hygiene and decreasing tooth mobility by creating a sufficient amount of attached gingiva needed for the long term maintenance.