Coronally advanced flap in association with connective tissue graft in the treatment of gingival recession

Vol. 11 – Number 41 – 2019 IMPLANT DENTAL NOTEBOOK Case report Page 46-50 Coronally advanced flap in association with connective tissue graft in the treatment of gingival recession Nicolas Nicchio Nicolini Calazans¹ Ingra Gagno Nicchio² Fausto Frizzera Borges Filho³ Cristiano Hooper Pascoal³ Rafael Dario Werneck4 Carla Letícia Alvarenga Leite5 Abstract Gingival recession (GR) is the apical migration of the gingiva with exposure of the root surface. Its presence and extent increase with age and occurs in most part of the population. The etiology is multifactorial and some predisposing factors have been proposed, such as deficient hygiene, bone dehiscence, thin gingival biotype, altered frenulum insertion, dental positioning, and toothbrushing trauma. Its main consequences are exposure of the root in the oral environment, with aesthetic and functional effects. Some types of surgical procedures can be performed to treat the GR. The aim of this study is to report the treatment of gingival recessions with coronally advanced flap in association with connective tissue graft (CTG). Patient AM, 32 years old, without systemic alterations and without interproximal bone loss, presented a gingival recession in an area with a history of a lateral periodontal cyst. The recession was classified as 1- according to the new classification of the periodontal diseases. The coverage of the recessions of teeth 11 and 12 was performed by coronally advanced flap in association with CTG. The addition of CTG is reported on the literature as an important factor to obtain a thicker tissue and obtain a more effective result in the medium and long term when compared only to the coronal placement of the flap. The proposed technique was able to treat the aesthetic alteration, to cover the exposed root area and to transform the gingival biotype into thick to increase the predictability and longevity of the procedure. Descriptors: Gingival recession, connective tissue, Periodontics, surgical flaps. 1 Discipline of Periodontics – Centro Universitário FAESA. 2 Department of Diagnosis and Surgery – Faculty of Dentistry Araraquara (UNESP), Araraquara, São Paulo, Brazil. 3 Prof. Holder of Periodontics and Implantology – Centro Universitário FAESA. 4 Prof. Holder of Occlusion and Clinical Prosthesis 1 – Centro Universitário FAESA. 5 Coord. Dentistry – FAESA University Center.