Gingival recession treatment with connective tissue graft – Elizabeth’s Story

Esthetic dentistry visual

Gingival recession treatment - Assessment

Gingival recessions with inflammation and functional problems

A female patient was unsatisfied with the appearance of her anterior restorations and complained about functional problems. Presented below is a systematic step sequence that was used for the planning and the execution of her life changing rehabilitation.

Dental restoration training

Gingival recession - Evaluation and planning

Comparison - Existing situation vs. detailed planning

The evaluation revealed the presence of traumatic occlusal contacts in the anterior. However, processes such as attrition, abrasion and erosion (especially combinations) can cause severe tooth wear.

Study models, an arbitrary face bow record and a registration in centric relation were taken. The newly defined occlusal position should be adequately verified and possibly adjusted.

 

partial dissection

Receding gums - Diagnosis

Partial dissection of the tissue

Gingival recessions were present, ranging from 2.0 to 4.0 mm and affecting the esthetic severely. These recessions were classified as Miller Class I. Envelope incisions and a partial dissection of the tissue were performed to create the implant bed for a connective tissue graft.

tunneling technique

Gingival recession - Treatment

Insertion of a connective tissue graft by Dr. Otto Zuhr

To improve the thickness of the gingiva and cover the previously exposed root surfaces, a tunneling technique in combination with a connective tissue graft harvested from the lateral palate was applied.

periodontology

Dental composite as an anchor

Soft tissue after insertion

This is a great example of using dental composite as an anchor for the sutures to stabilize the augmented tissue in the desired coronal position.

esthetic Dental Restoration

Gingival recession surgery - Before and after

Appearance after the healing period prior to prosthetic treatment

The surgical healing period was 6 months in total, with the possibility for definitive treatment of the posterior region and of the mandibular anterior region in between.

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Receding gums treatment - Conclusion

Lateral view with restored front and canine guidance at the 2 year follow up on the gingival recession treatment

In conclusion, when fabricating the definitive restorations, several materials are available. Ceramic materials are widely indicated. Since they are able to fulfill esthetic and biological requirements with optimal mechanical and optical properties. Beuer et al.30

Treatment Team: Otto Zuhr, Dr med dent | Reza Saeidi Pour, Dr med dent | Stefan Frei, MDT

 

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Prof. Mark Hürzeler and Dr. Otto Zuhr’s goal has been for a long time to identify and implement evidence-based approaches in daily practice for the benefit of our patients.