Treatment of Deep Isolated Gingival Recession Defects Affecting Mandibular Incisors: A Novel Interdisciplinary Orthodontic-Mucogingival Approach
Mauro Fadda, Martina Stefanini, Alexandra Rendón, Matteo Sangiorgi, Lorenzo Tavelli, Giovanni Zucchelli
Abstract
Tooth malposition negatively affects the outcome of root coverage procedures, limiting chances for complete root coverage (CRC). This case series introduces a combined orthodontic-mucogingival approach for the treatment of deep (> 4 mm) isolated gingival recession defects affecting mandibular incisors with a buccally displaced root. Twenty patients were treated with a novel orthodontic device (FZ Root Torque Controller) for selective correction of tooth malposition at the affected site, turning all isolated recessions into Miller Classes I and II. Subsequent surgical treatment of the gingival recession with a vertically-coronally advanced flap plus a connective tissue graft achieved 90% CRC at the 1-year follow-up, with a recession reduction of 5.6 ± 1.5 mm, a 1.24 ± 0.24 mm increase in gingival thickness, and improved esthetic outcomes.