whats your treatment plan

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Posted on By hamed rahimi In Periodontics

hi
this case is a 27year old man
no bone loss
no periodontal problem
just soft tissue recession in the palatal root of first molar left and right side,whats your treatment plan for this case?thanks alot


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6 Comments

Hi Hamed. First, there is bone loss at least on the palatal. Otherwise, there would be no recession. The question I would have is whether there is any occlusal trauma on those molars. The molar in your photo looks over-erupted and may be in trauma. Check mobility and treat accordingly. If no mobility and the patient has no sensitivity, I would monitor to see if the situation has stabilized and may be maintainable.


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hi
the patient has severe sensitivity
the other first molar is the same
and there is no trauma and mobility
this picture is from the other first molar
we see recession in second premolar and molars in this area


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History of smoking? These are always very challenging to gain any significant root coverage as we can not mobilize and coronally advance the palatal flap. Adjust and take out of occlusion, treat with desensitizer/sealant for dentinal tubules and observe....if you wish to attempt root coverage a rotated partial thickness flap is your best chance. Good luck. Dr. S


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no history of smoking,thanks a lot for your helping,dr rahimi


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Hamed...I did have a similar case and the cause in that case was a balancing occlusal interference...so agree with both Drs Salama...check occlusal interferences and also it may help to look carefully at the diagnostic study casts for wear facets.


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thanks a lot ,i will chech the occ balance again on cast


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