How to correct a Recesson defect associated with interproximal bone loss and a diastema.
30 y/o female came with a Chief Complain : "I want to save my tooth and cover the root exposed with gingiva"
Patient underwent Orthodontic therapy a year ago, she mentions they moved her teeth in 3 months. She had a lot of pain on all her teeth. She noticed then her gingiva started to shrink on # 9. Now she has a class III Miller recession defect, as well as a class I mobility on tooth # 9. She comes to me seeking for a chance on saving her tooth.
The treatment option that comes to my mind is:
With orthodontics close the diastema between # 9 and 10. Have endodontic treatment performed and then move # 9 towards the lingual in a body movement, so as to enhance the osseous width on the buccal, then extrude it so as to reduce the distance between the contact point and the osseous crest. Then I could do a CTG to cover the recession. Finally crown # 9 and do a fix retainer on the lingual of all 6 maxillary anteriors so as to improve the support on # 9.
Do you have any other alternatives?? Comments and opinions are more than welcome.