Gingival recession treatment with connective tissue graft

Elizabeth’s Story

Gingival Recession Treatment - Esthetic results

Gingival recession - Assessment

Receding gums with inflammation and functional problems – Treatment with a connective tissue graft.

This story provides a multidisciplinary overview of a treatment that challenges dentists, periodontal surgeons and dental technicians alike and requires coordinated teamwork.

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.

Gingival Recession Treatment - Evaluation and Planning

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.


Gingival Recession Treatment - Partial dissection

Receding gums - Diagnosis

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. Modified envelope incisions and a partial dissection of the tissue were performed to create the implant bed for the connective tissue graft (CTG). The CTG was harvested from the lateral palate.

Gingival recession treatment - 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.

Watch the step-by-step tutorial by Dr. Otto Zuhr!

Connective Tissue Graft - Dental Composite as Anchor

Desired coronal position

In picture: Stabilization sutures after tunneling procedure

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.

Gingival recession surgery - Before and after

Gingival recession surgery - Before and after

The picture: 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.

Gingival recession surgery - Results

Gums recession treatment - Conclusion

The picture: 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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