Article:

Root coverage in the mandibular incisor region is a regular challenge in periodontal plastic surgery for several reasons. First, there is often a high frenal attachment, shallow vestibule and thin or nonexistent quantities of keratinized and attached gingiva. This poses problems during root coverage procedures due to compromised blood supply as well as excess flap tension which hinders graft stabilization. Furthermore, close root proximity and thin interproximal bone may lead to little to no papillary gingiva available for adequate flap design and suturing. Finally, anterior crowding often results in labially positioned incisors which may have large facial dehiscences. Due to these anatomical considerations, clinicians are often limited as far as choosing the proper technique for predictable root coverage. This article presents a detailed case report as well as other supporting cases demonstrating predictable root coverage utilizing a subepithelial connective tissue graft.