Management of Multiple Recession-Type Defects After Orthodontic Therapy: A Clinical Report Based on Scientific Evidence.

Abstract

Treatment of multiple recession-type defects (MRTDs) developed subsequent to orthodontic therapy requires a solid knowledge of the anatomy/characteristics of the defects. Surgical approaches based on the use of subepithelial connective tissue grafts (SCTGs) are considered the "gold standard" for the treatment of MRTDs, but their use may be limited by the availability of donor tissue. The objective of this case report is to present the outcomes of treatment achieved by a SCTG in a patient presenting MRTDs in all four quadrants of the mouth.A non-smoking 23-year-old female patient presenting 15 Miller Class I or II gingival recessions (GRs) at anterior and posterior teeth of the maxilla and mandible, developed after orthodontic therapy, was referred for treatment in March 2013. Defects were treated using four SCTG-based procedures using grafts harvested from two donor sites at different time frames. Twenty-four months after treatment, gingival thickness modification led to esthetic and functional results.The use of SCTGs harvested twice from the same donor site for the treatment of MRTDs led to safe and predictable outcomes (i.e., clinically significant gains in GR depth, attachment level, and esthetics).