PMC4355546_01
A severe deep class II Miller gingival recessions in anterior mandibular tooth.
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Fig1
A deep class II Miller recession with the lack of attached gingiva, and narrow band of keratinized tissue was observed (Figure 1).
Surgical procedure: bed preparation, root surface preparation, covering bone dehiscence with xenograft bone particles mixed with blood, stabilization of connective tissue graft over bone graft, double papilla and coronally positioned flap.
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Fig2
Thus, it was extended until it could be passively positioned coronally over the defect without tension (Figure 2). The flap was sutured in place with sling sutures (Figure 2).
Post operative follow up showed complete root coverage and significant gain of keratinized tissue. Photographs were taken 2, 4, 8, and 12 weeks (left to right) after surgical intervention.
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Fig3
The grafted area healed well and complete coverage was achieved at 12-monthfollow-up visit (Figure 3).
Clinical improvement of different clinical parameters at baseline, 1- and six-year follow up.
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Fig4
There was also no change in probing depthcompared to the valuebefore thesurgery (Figure 4).
Remnants of xenograft bone particles over denuded root (left) in comparison to intact neighboringsite(right) at six-year follow up. Clinical view represents full coverage of the defect.
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Fig5
The remnant particles of xenograft were still present on the root surfaces (Figure 5).