A Single Step Surgical approach for Root coverage and Vestibuloplasty in Mandibular anterior teeth- A Case Study.
Journal Title: International Journal of Dental Science and Innovative Research (IJDSIR) - Year 2019, Vol 2, Issue 3
Abstract
Mandibular teeth face more challenge and are difficult to treat because of certain anatomical factors like thin gingival biotype, shallow vestibular depth and high frenum attachment. Recession in the mandibular anterior teeth region not only results into esthetic problem but also difficulty in oral care due to shallow vestibule .Gingival recession is an issue which is faced both by the clinician and the patient. The treatment of gingival recession is important as its presence compromises both esthetic and gingival health. Mucogingival surgery done for recession coverage becomes a necessity when esthetics, dentinal sensitivity, and carious and noncarious cervical lesions poses a problem [1]. Moreover, the presence of recession defects creates unfavorable contour of the gingival margin or leads to insufficient keratinized gingiva, thereby, limiting the proper plaque control. From the past few decades, several surgical techniques, not only for the preservation but also for the increase of the gingival dimension as part of periodontal treatment, were described in the periodontal literature [2,3,4,5,6]. Various factors have to be taken care in selecting the procedure of choice for root coverage like extent of recession, width of attached gingiva, aesthetic concern, patient comfort, and the position of tooth in the arch [7, 8]. The majority of the published literature on Miller Class I and Class II soft-tissue recession have demonstrated better results with Subepithelial Connective Tissue Graft (SCTG), hence, regarded as “gold standard” approach for root-coverage procedures [9]. On the contrary, a survey conducted by Zaher et al., indicated that FGG was the favourite choice of the clinicians for the management of denuded root surface despite of its disadvantages, followed by the SCTG, and the CAF [10].The 1996 World Workshop in Periodontics has stressed primarily on regaining gingival tissue coverage over the denuded root surface, with the ultimate goal of complete root coverage (CRC) and esthetics satisfaction rather than increasing width of attached gingiva [11]. Recession with shallow vestibule is also a common problem in mandibular anterior teeth region . Bohannan in studying procedures for deepening the vestibule found that it is necessary to expose bone at the depth of the incision to achieve a lasting result. This gave rise in the early 1960s to the periosteal separation technique by Corn which did produce the apical scar and a deepened vestibule [12].Hence a single step procedure can be performed using Free gingival graft and periosteal fenestration for the treatment of mandibular anterior teethrecession and shallow vestibule.
Authors and Affiliations
Tambe Lashika V.
Keywords
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