ABSTRACT
Mucogingival deformities are a group of defects that occur around the cervical area of the teeth. Gingival recession is the most common type of these deformities. It might happen separately or with other related deformities like thin gingival biotypes, shallow vestibule, high frenal attachment, and cervical dental steps. Recent classification of mucogingival deformity matrix has collectively grouped gingival recession types with other mucogingival deformities and dental steps to establish the proper diagnosis and evaluate surgical/restorative management and prognosis of the treatment outcomes. The following case presentations have presented with a technical review, clinical evaluation, and surgical and/or restorative treatment according to the recent matrix.
ABSTRACT
Introduction: Gingival recession (GR) with cervical tooth wear is a major concern for patients on the prominent maxillary canines, from both esthetic and dentine hypersensitivity points of view. Hypersensitivity could be treated nonsurgically; however, esthetics remain the major patients' concern that mostly requires surgical intervention for covering the denuded root surface. Several surgical procedures are applied successfully for covering single and multiple gingival recession; however, these procedures are sensitive procedures and not always predictable. Semilunar coronally repositioned flap (SCRF) is a very simple procedure that found to be very predictable for covering a single recession in presence of sufficient keratinized gingiva apical to the recession. The procedure provides better clinical outcome by involving less adjacent papillary tissue that maintains greater blood supply and achieves maximum flap stability with mattress sutures with minimal postoperative complications. Therefore, this case report is aimed at explaining the simplicity of this surgical procedure in the presence of wide keratinized tissue around the recession and starting the restorative procedure after a sufficient soft tissue healing period. Case Presentation. 42-year-old systemically healthy female patient referred with a single wide gingival type 1 (RT1) and cervical wear around tooth #43. A semilunar coronally repositioned flap was released and advanced coronally to cover the denuded root totally; then, the flap stabilized by three mattress sutures, and complete root coverage was achieved. Six months later, the cervical lesion was restored with composite filling material. Sixteen-month and 32-month postoperative follow-up revealed full coverage of the denuded root surface with firm stable gingiva; later, the gingiva in the area looked stable and healthy. Conclusion: Using SCRF in treating RT1 recession in the presence of wide keratinized gingiva is very promising surgical intervention for receded root coverage that requires less technical skill.
ABSTRACT
Coronally advanced flap (CAF) by tunneling procedure was applied on four cases of gingival recession. Post-operative follow-up, at different time breaks, recorded full coverage of almost all receded root surfaces. The technique and the clinical outcome of this technique will be demonstrated in this case series report.
ABSTRACT
OBJECTIVE: The aim of this study was to analyze tooth movement and arch width changes in maxillary dentition following nonextraction treatment with orthodontic mini-implant (OMI) anchorage in Class II division 1 malocclusions. METHODS: Seventeen adult patients diagnosed with Angle's Class II division 1 malocclusion were treated by nonextraction with OMIs as anchorage for distalization of whole maxillary dentition. Three-dimensional virtual maxillary models were superimposed with the best-fit method at the pretreatment and post-treatment stages. Linear, angular, and arch width variables were measured using Rapidform 2006 software, and analyzed by the paired t-test. RESULTS: All maxillary teeth showed statistically significant movement posteriorly (p 0.05) and the intercanine, interfirst premolar, intersecond premolar, and interfirst molar widths increased significantly (2.2 mm, p < 0.01; 2.2 mm, p < 0.05; 1.9 mm, p < 0.01; 2.0 mm, p < 0.01; respectively). CONCLUSIONS: Nonextraction treatment with OMI anchorage for Class II division 1 malocclusions could retract the whole maxillary dentition to achieve a Class I canine and molar relationship without a change in the vertical position of the teeth; however, the second molars were significantly extruded. Simultaneously, the maxillary arch was shown to be expanded with distal-in rotation of the molars.