Treatment of Gingival Recessions Class II Miller in Lower Jaw with Coronary Advanced Flap and Connective Tissue Graft-Case Report

Summary Background/Aim: Gingival recession is defined as apical migration if the gingival margin associated with exposure of the cement - enamel junction. The gingival recessions are major esthetic concern in patients at any age. In cases with esthetic and functional considerations mucogingival surgery is indicated. The advantages of CAF with or without CTG are making this procedure highly recommended in the esthetic zone. The results are predictable about root coverage, widening if the gingival tissues and esthetics. The aim of the recent case report is to demonstrate the succesfull combination of coronally advanced flap with connective tissue graft in the treatment of wide and deep gingival recessions. Case Report: Female patient seeking consultation with great concern” not to lose the lower canines”. She noticed elongation of the teeth in the recent years complained with tenderness while brushing them. The initial examination showed presence of multiple gingival recessions in the upper and the lower jaw. Full periodontal status was taken and following diagnosis was established – dental plaque induced gingivitis, class II gingival recession in teeth #33 and #43 (Miller`s classification), RT1 by Cairo. After cause-related therapy two surgical procedures were performed in separate sessions. Both gingival recessions were surgically treated by means of CAF with CTG. Conclusions: Despite the limitating factors such as lack of keratinized tissue in the patient’s mandible that rather difficult the performance of the technique of choise, the coronally advanced flap with connective tissue graft is predictable technique for full root coverage.