Gingival recession in the anterior maxillary region presents both functional and esthetic concerns, particularly when it affects the smile zone. Root exposure may lead to dentin hypersensitivity, plaque accumulation, and compromised gingival harmony. Periodontal plastic surgery techniques have been developed to restore gingival coverage and improve soft tissue thickness, demonstrating predictable results with generally favorable and well-documented outcomes. This case report describes the treatment of localized gingival recession affecting the maxillary left canine (tooth #11, Universal Numbering System) using a coronally advanced buccal flap combined with a subepithelial connective tissue graft harvested from the palate. After administration of local anesthesia (2% lidocaine with 1:100,000 epinephrine), a partial-thickness coronally advanced buccal flap was carefully elevated at the recipient site, and the exposed root surface was thoroughly debrided. A subepithelial connective tissue graft harvested from the palatal donor site was trimmed, positioned over the recession defect, and stabilized with 3-0 chromic gut absorbable sutures. The buccal flap was then coronally advanced to fully cover the graft and secured with interrupted 3-0 chromic gut sutures to achieve tension-free closure. Postoperative healing progressed without complications. Follow-up evaluation demonstrated improved gingival thickness and satisfactory root coverage, with a reduction of gingival recession from approximately 3 mm preoperatively to complete root coverage at the treated site. Probing depth remained stable at 2 mm, and enhanced esthetic integration with the surrounding tissues was observed. This approach appears to be a reliable technique in this case, demonstrating favorable clinical and esthetic outcomes for managing gingival recession in the anterior esthetic zone while improving soft tissue stability and patient satisfaction.
Cavero et al. (Fri,) studied this question.