A Two-Step Surgical Approach with Flattening of the Root Surface to Treat Localized Gingival Recessions Affecting Mandibular Incisors: A Case Series Report

Root coverage in the anterior mandible is challenging due to a thin gingiva, shallow vestibule, and/or high frenulum. This case series reports on the flattening of the root surface to create a new emergence profile conceived with a two-step surgical approach aimed at providing more space for the graft, increasing the thickness of the gingival margin, and getting extra soft tissue in the open area of the recession. A total of 10 patients with recessions affecting the mandibular incisors were treated to evaluate this two-step approach, which included odontoplasty of the root followed by a connective tissue graft. At 1 year, the mean coverage was 100% in Class II recessions, and 80.5% in Class III. The mean keratinized tissue increase was 5.80 ± 1.75 mm. This surgical approach could be proposed as an alternative when treating mandibular anterior teeth with root prominence or with a buccally tilted position.