(42) Coronally Advanced Flap to Manage Recession RT2 in the Esthetic Zone in a High-Risk Patient (Smoker/Bruxer), 1- year Clinical Follow-up: A Case Report

Introduction: Periodontal plastic surgery and root coverage procedures are well established and scientifically proven. With the advancement of periodontal plastic surgical techniques, the scope of procedures has expanded, and outcomes can be predictable, if treatment guidelines are followed. However, the results can be less than optimal in high-risk patients. Smoking is considered a significant risk factor and can compromise the predictability and success of the procedure. Bruxism is a parafunctional habit that may have a negative influence on healing as well. Few studies with long term follow-up exist in this regard. The aim of this case report is to share a step-by-step treatment of RT2 recession in the esthetic zone in a high-risk patient.

Methods: 34-yom presented to Graduate Periodontology & Implantology department. Patient’s chief complaint was mild sensitivity and “I don’t like how this tooth (patient points to #6) looks.” Clinical exam reveals previously placed class V composite restoration on #6, notching and no clear demarcation of the CEJ. When these challenges are present the result can be less than optimal. The treatment option presented to the patient was a coronally advanced flap with an autogenous connective tissue graft. In this study, an initial surgery with connective tissue graft via tunnel technique was performed and secondarily a coronally advanced flap with connective tissue graft. Clinical analysis was performed at 1- year follow-up.

Results: Complete root coverage was achieved ten months following the secondary surgery of coronally advanced flap with connective tissue graft.

Conclusions: In this case report a favorable clinical and patient-centered outcome was achieved and maintained in a high-risk patient profile utilizing a combination of bilaminar surgical techniques.

Lead Author's Contributions to the Research Project. : Lead author was responsible for clinical management of the patient, performing any and all surgical procedures and documentation.