Root coverage

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Posted on By Romani Nashid In Soft Tissue Enhancement

Healthy 24 yr old male with upper and lower anterior crowding. Tooth#11 is displaced buccally with over 5mm buccal recession. Plan is to place connective tissue graft. I was wondering what would be a better flap design (trapezoidal or Lateral Pedicle flap). Please find photos and radiograph attached. Thanks


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3 Comments

Hi Romani -I try to discover the reason for the recession and in this case I wonder if you feel the canines are lying buccal outside the arch and I would worry as to both short and lantern success of tissue grafting
Maybe consider Ortho in combination with future graft as ultimately the tissue is reliant on the bone present


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Thanks for your feedback Barry. I agree with you. I have discussed with pt possible reasons behind recession and that he will need Ortho tx for long term stability of the tissues. He can not afford Ortho at this time. I also often see orthodontists asking for tissue graft before starting Ortho!


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Hi yes I have debated this myself
However, in this case the canines are outside buccal shelf and whilst you may increase attached mucosa I believe you are unlikely to achieve long term root coverage without Ortho.
I have seen my own cases soft tissue gain on root surfaces with Ortho alone
If you graft before Ortho you're likely to need revision post Ortho


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