
Previous situation
Dear Colleagues,
Today we present the case of a patient who consulted us having been referred by the orthodontist after orthodontic treatment. She presented with a recession in the central lower right incisor as well as a high frenal attachment.
The patient had a very fine gingival biotype that went as far as to cause transparency in the roots of neighbouring teeth. We made a tunnel access and grafted using connective tissue taken from the palate. In this patient’s case, we obtained very limited connective tissue with a high predominance of fatty tissue.
Once the graft was performed, we oberved that it had covered part of the recession but not all of it. Subsequently, we decided to wait 4 months and regraft using the same technique, but this time adding a frenectomy.
You can observe the state of the second graft after 15 days and after 5 months.
- Previous situation
- Access
- Tunnel
- Connective tissue graft
- After 4 months
- Second graft
- Sutures
- Appearance after 15 days
- Appearance after 5 months
- Side view
This is a wonderful case report. Can you elaborate or more photos showing how you added frenectomy with tunneling. ?
Thank you for your comment Dr Lee, the technique was a mixed in between Edlan Mejchar and Kazanjian vestibuloplasty, we don’t have more pictures of the procedure but you can check out this case which is very similir https://www.dloralsurgery.com/covering-recessions-after-orthodontics/
Warmest regards
Juan Lara Chao