Multiple Root Coverage in a Patient With Periodontis - Clinical Case

Case Description: Male patient, 52 years of age, non-smoker, showed-up in the appointment with complaints of tooth hypersensitivity and concerns about the generalized gingival recessions. After a diagnosis of generalized chronic moderate periodontitis, a cause-related periodontal therapy was performed. Posterior to the re-evaluation, indicating a healthy periodontal condition, patient functional concerns persisted regarding the presence of the multiple gingival recession. After detailed discussion with the patient about the several therapeutic options and their prognosis, multiple root coverage in the 1st quadrant (11, 12, 13 and 14) and in the 2nd quadrant (21, 22, 23 and 24) was decided to do in a first instance, using coronal repositioning flaps and site-specific subepithelial connective tissue grafts (SCTG's). The aim of this clinical case is to describe, step by step, the entire surgical process performed as well as to illustrate the initial 6th month follow-up condition. Discussion: The selection of the surgical technique for the treatment of gingival recessions depends on several factors. Anatomical conditions, long-term stability and patient preferences and expectations should be taken into consideration when elaborating the treatment plan. The use of site-specific SCTG's is related to the long-term stability of root coverage in the areas of higher risk of relapse (patient main concern) and not with aesthetic reasons. Conclusion: Coronal repositioning flaps and site-specific subepithelial connective tissue grafts (SCTG's), can be successfully used in multiple root coverage. Keywords: gingival recessions, periodontal plastic surgery, root coverage, periodontal long-term stability, sub-epithelial connective tissue graft, coronally advanced flap