Jesse M Sorrentino1, Dennis P Tarnow. 1. Ashman Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY, USA.
Abstract
BACKGROUND: This case report describes a method for coronally repositioning gingiva for root coverage over the maxillary central incisors while simultaneously performing a frenectomy. METHODS: The patient was a healthy 43-year-old Brazilian female. Her chief complaint pertained to the unesthetic appearance of the gingival recession involving both maxillary central incisors. Intraoral examination revealed a thick biotype with an adequate band of keratinized gingiva, Miller Class I mucogingival defects, and a broad frenum extending beyond the mucogingival junction. The surgical technique used to treat the areas of recession involved making semilunar incisions over the maxillary central incisors that blended into a frenectomy. RESULTS: Complete root coverage was achieved over the maxillary central incisors that initially presented with 2 mm of recession on the facial surface. The residual frenum no longer attached at a point coronal to the mucogingival margin. Small white scars were detectable at the mucogingival junctions above both incisors but were not an esthetic concern because of the patient's moderate smile line. CONCLUSIONS: This case report shows the possibility of applying a combined semilunar coronally repositioned flap with a frenectomy in a case in which maxillary central incisors were impinged upon by a broad aberrant frenum, probed </=3 mm, and presented with Miller Class I mucogingival defects. Further controlled investigations are needed to define the efficacy of this surgical technique.
BACKGROUND: This case report describes a method for coronally repositioning gingiva for root coverage over the maxillary central incisors while simultaneously performing a frenectomy. METHODS: The patient was a healthy 43-year-old Brazilian female. Her chief complaint pertained to the unesthetic appearance of the gingival recession involving both maxillary central incisors. Intraoral examination revealed a thick biotype with an adequate band of keratinized gingiva, Miller Class I mucogingival defects, and a broad frenum extending beyond the mucogingival junction. The surgical technique used to treat the areas of recession involved making semilunar incisions over the maxillary central incisors that blended into a frenectomy. RESULTS: Complete root coverage was achieved over the maxillary central incisors that initially presented with 2 mm of recession on the facial surface. The residual frenum no longer attached at a point coronal to the mucogingival margin. Small white scars were detectable at the mucogingival junctions above both incisors but were not an esthetic concern because of the patient's moderate smile line. CONCLUSIONS: This case report shows the possibility of applying a combined semilunar coronally repositioned flap with a frenectomy in a case in which maxillary central incisors were impinged upon by a broad aberrant frenum, probed </=3 mm, and presented with Miller Class I mucogingival defects. Further controlled investigations are needed to define the efficacy of this surgical technique.