Histologic evaluation of new attachment utilizing a titanium-reinforced barrier membrane in a mucogingival recession defect. A case report.

Guided tissue regeneration was USED to treat a localized, deep, buccal recession on a mandibular left central incisor. This tooth was labially displaced and scheduled for extraction for orthodontic reasons. The mucogingival defect had 7 mm of facial gingival recession, and 4 mm mid-buccal probing depths. The attachment loss was 11 mm. There was no attached gingiva. At surgery the root was notched as landmarks for assessing the histological examination. A titanium reinforced barrier membrane was left in place for 4 weeks. At the time of extraction, 9 months post-initial treatment, there was a gain of 3 mm of root coverage and 1 mm of gingiva. The tooth and facial tissues were removed by block section for histologic evaluation. The root surface exhibited a total amount of a histologic new connective tissue attachment of 5.6 mm and regeneration of a new bone growth of 6.7 mm of bone. The histologic findings demonstrated that the coronal extent of the new attachment and new facial bone, 9 months after guided tissue regeneration treatment, were located coronal to the preoperative location, in a root surface previously exposed by a deep, long-standing recession.