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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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


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!


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