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Gingival Recession of Lower Incisor

Periodontal Case Study

Soft tissue graft for increasing attached gingiva
Soft tissue recession of the lower incisors is increasingly becoming a problem in young adults. In particular, it is often observed following completion of orthodontic treatment. Soft tissue grafting can improve the prognosis of the affected teeth. However, it can be a particularly technique sensitive procedure due to a soft tissue biotype, presence of frenum and limited attached gingiva.

A young female patient presented with concerns of gingival recession of her lower incisor (31). She noticed some discomfort when brushing in the region and also reported sensitivity to cold stimuli. Clinical examination revealed a type II Miller’s classification of recession defect, no attached gingiva and a high frenal attachment. The gingival soft tissues were of a thin biotype.

It was decided to augment the labial tissues with a free gingival graft. A split thickness buccal flap was elevated to expose the periosteum. The 31 root planed to a glassy surface and treated with EDTA. A free gingival graft was harvested from the hard palate and sutured to the periosteum. A review after 8 weeks revealed a thick band of attached gingiva with almost complete root coverage.