PMC6476143_01
(a to c) Pretreatment clinical and radiographic images showing a deep Miller Class III GR of the tooth #2. Note a severe bone loss of the tooth and apex exposure.
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University, Casablanca, Morocco, with esthetic complaints related to GR (Figures 1(a)-1(c)). Upon intraoral clinical examination, a deep Miller Class III GR was detected on the buccal aspect of the tooth #2.
Three weeks after endodontic treatment showing osseous remineralization in the apical area.
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An endodontic treatment was performed on the tooth #2 (Figure 2).
Laterally positioned flap to cover GR on the tooth #2. (a) Baseline GR. (b) Illustration of the laterally positioned flap design. Black lines represent parallel vertical incisions. Blue lines represent the marginal epithelium removed to prepare a recipient bed. (c) Postoperative view.
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The chosen treatment for root coverage consisted of a lateral positioned flap (LPF) (there was a sufficient band of keratinized tissue (KT) laterally to the recession) (Figure 3(a)). Following local anesthesia, the recipient site was prepared to accommodate the LPF (Figure 3(b)). The prepared flap was positioned laterally to cover the GR and the removed epithelium from the mesial area of tooth #2, which was stabilized with discontinued periosteal sutures (Figure 3(c)).
Clinical photograph at 6 months after the surgery showing a consistent reduction of baseline recession depth.
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At 6 months, a consistent reduction of baseline recession depth (2/3 of initial baseline or 70% of root coverage) was observed (Figure 4) and an orthodontic treatment was then started in order to correct traumatic occlusion (Figures 5(a)-5(c)).
Two-year follow-up. (a, b) Facial view. Note a consistent recession reduction. (c) Periapical radiograph.
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At 6 months, a consistent reduction of baseline recession depth (2/3 of initial baseline or 70% of root coverage) was observed (Figure 4) and an orthodontic treatment was then started in order to correct traumatic occlusion (Figures 5(a)-5(c)).
Clinical outcomes at 6 years of follow-up, at baseline, and after completion of treatment.
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No bleeding on probing was observed during or after orthodontic treatment, and no GR was observed at the donor site (Figure 6).