Integration between Periodontics and Orthodontics for the treatment of gingival recession

Vol. 13 – Number 50 – 2022 IMPLANT DENTISTRY NOTEBOOK Case report Page 56-61 Integration between Periodontics and Orthodontics for the treatment of gingival recession Nicolas Nicchio Nicolini Calazans1 Licínia Maria Ferreira Pignaton2 Deise Cunha3 Fausto Frizzera4 Abstract Gingival recession is the apical migration of the marginal gingiva beyond the cemento-enamel junction, it is observed in a large part of the population. Patients with thin gingival phenotype, absence of keratinized gingiva, altered frenulum insertion, and teeth positioned outside the alveolar ridge may present this condition. In this clinical case, the patient sought dental care complaining of dentinal hypersensitivity in the region of the anterior teeth. After clinical and radiographic examinations, a 2 mm gingival recession of type 1- on tooth 32, absence of keratinized gingiva, altered frenulum insertion, and malpositioned teeth were observed. To deal with her complaint, an integrated treatment plan was created between Orthodontics and Periodontics. First, the patient used an orthodontic appliance to correctly position the teeth in the alveolar ridge, reducing gingival recession and providing a more favorable surgical bed for a grafting procedure. After orthodontic treatment, a free gingival graft was performed, which achieved complete root coverage, changed the gingival phenotype from thin to thick, and keratinized gingiva gain, thus preventing reinsertion of the frenulums and the recurrence of gingival recession. The combination of orthodontic movements and periodontal surgical procedures proved to be effective for treating gingival recession and eliminating complaints of dentinal hypersensitivity. Descriptors: Orthodontics, Periodontics, gingival recession, dentin sensitivity. 1 Diagnosis and Surgery Department – Araraquara Dental School – UNESP. 2 Periodontics Discipline – UFES. 3 Orthodontics Department – ABO – Vitória/ES. 4 Department of Periodontics – FAESA University Center. DOI: 10.24077/2022;13502452255