- 期刊
Phenotype Modification and Root Coverage Using the Tunneling Technique for Multiple Gingival Recession after Orthodontic Treatment
摘要
Objective: Buccal gingival recession of the mandibular anterior teeth occasionally occurs in patients undergoing orthodontic treatment. The following factors have been identified as being associated with an increased risk of developing this condition: thin phenotype, root prominence, buccal movement of the teeth during treatment, tooth movement extending beyond the physiological range, and lingual fixed retainer deformation. Such patients frequently experience bone dehiscence in the mandibular anterior region following orthodontic treatment, which results in thin gingiva and subsequent gingival recession. The objective of this article is to present feasible surgical techniques for gingival recession following orthodontic treatment. Materials and methods: Two cases were classified as at least RT2 gingival recession. Surgeries were performed using the tunneling technique in conjunction with de-epithelialized free gingival grafts (d-FGGs) with 2-mm thickness to achieve phenotype modification and root coverage. Case 1 represents the most common type of recession, characterized by gradual recession of the gingiva over time. The procedure was conducted using the papilla access tunneling technique. Case 2 involved recession caused by substantial tooth movement over a relatively short period, with one tooth exhibiting severe recession. In this case, the laterally closed tunneling technique was employed. In both surgeries, periosteum anchorage sutures were employed to enhance the predictability of surgical outcomes. The recession depth and gingival thickness in the mandibular anterior region were recorded. Results: In Case 1, the mean root coverage rate was 88%, with gingival thickness reaching 2 mm. In Case 2, the average root coverage rate was 100%, with gingival thickness also reaching 2 mm. Conclusion: The combination of the tunneling technique with a 2-mm-thick d-FGG and periosteum anchorage sutures can achieve both phenotype modification and root coverage in cases with thin gingiva and gingival recession following orthodontic treatment.