Treatment of a Gingival Recession With In-Office Orthodontic Aligners and Gingival Graft.

Abstract

Objective: Gingival recession is a complication that can occur after orthodontic treatment, and its cause is still very controversial in the literature. The objective of this study was to report a clinical case of orthodontic retreatment conducted with in-office aligners and root coverage using free gingival graft, connective tissue graft, and Emdogaim for a patient with severe gingival recession.

Clinical considerations: This report presents a potential solution to correct a gingival recession with in-office clear aligner. A mandibular left lateral incisor whose root was positioned buccally to the bone plate, likely due to improper bonding of a fractured orthodontic retainer. The treatment consisted of 10 in-office aligners, which effectively repositioned the root within the alveolus. After the orthodontic retreatment, the patient underwent gingival grafting surgery, which was successful due to the accurate positioning of the root in the socket, influencing bone deposition in the area. Subsequent 4-year follow-up showed treatment stability, mainly in the soft tissue area.

Conclusion: Within the limitations of this case report, the in-office aligners facilitated individualized and precise movements, allowing for torque adjustments when necessary. Besides that, the improved root positioning facilitated successful surgical procedures for covering the gingival recession, including the free gingival graft (FGG) and connective tissue graft with Emdogain (CTG + Emdogain).

Clinical significance: This case report presents an orthodontic treatment alternative for the multidisciplinary correction of a gingival recession, meeting the esthetic and functional demands of an adult patient.