Utilização de enxerto livre subepitelial para correção de recessão gengival pós-tratamento ortodôntico: um relato de caso clínico

Abstract

Gingival recession (GR) is the apical displacement of the gingival margin, resulting from different etiologies, including orthodontic treatment, especially in proclination movements in thin periodontium. A possible treatment for this condition is the root coverage approach with gingival grafts. The objective was to report a case of root coverage after orthodontic treatment using free subepithelial graft. A 23-year-old normossystemic patient, who underwent 9 years of orthodontic treatment, presented with a gingival recession classified as RT1 A-, 4 mm in apical-coronal extension and 3 mm in width, on tooth 31. With the aid of Cone Beam Computed Tomography, a total absence of buccal bone plate was noted. The GR correction technique chosen was the free subepithelial graft. After basic periodontal treatment, microblades were used for intrasucular incision around tooth 31 and, with the aid of tunnelers, a receptor bed of approximately 6 mm in length proximal to the GR was created. Using the Harris technique, the free subepithelial graft from the palate region, 11 mm long and 2 mm thick, was removed. The graft was then positioned in the recipient site and sutured with 6-0 resorbable suture thread, as well as suturing in the donor region. The follow-up of the case was carried out in the period of 7, 14 days, 1 month and 3 months after the surgery, being observed, at the end, 3 mm of coverage. Thus, we can conclude that the subepithelial free graft approach proved to be satisfactory for correcting the gingival recession of the tooth in question.