Content area
Full text
ABSTRACT:
Gingival recession in anterior teeth is of huge concern due to esthetic reasons. Root coverage is being achieved by a variety of mucogingival techniques. The presence of shallow vestibule, inadequate width of attached gingival, aberrant frenum pull may pose a challenge to cover the denuded root surface for which several independent & effective surgical solutions are reported in the literature. This article reports three such cases of gingival recession, which have been treated with bridge flap technique. This technique can be used as a single surgical entity for covering multiple gingival recession defects, increasing depth of vestibule & also solving the problem of abnormal frenum pull, without a second surgical site. The treated cases demonstrated adequate root coverage & increase in width of attached gingival at 6 months follow up
Key words: bridge flap, root coverage, attached gingival, gingival recession, mucogingival surgery, coronally advanced flap
INTRODUCTION
Gingival recession is the exposure of the root surface by an apical shift in the position of gingiva.[1] Marginal tissue recession results in dentinal hypersensitivity, esthetic problems and tendency for root caries. Therefore root coverage procedures have become an important part of regenerative periodontal therapy.[2] Among the various surgical techniques that have been advocated for treating multiple recession complicated with either inadequate width of attached gingival, aberrant frenum pull or shallow vestibule, the bridge flap have shown better root coverage predictability & esthetics. The primary advantage is that it does not require a separate second frenectomy procedure, can be used for covering multiple gingival recessions without a second surgical site. The double lateral bridging technique was proposed by Marggraf. [3] This technique utilizes the combination of a coronally advanced flap and modified Edlan & Mejchar technique.[4] This paper report the surgical management of three patients with bridge flap for coverage of denuded root surfaces.
CASE REPORTS
Three patients with the complaints of recession, esthetics and sensitivity in lower anterior teeth were examined. Various clinical parameters were recorded; gingival recession GR (i.e. distance between CEJ & free gingival margin), probing pocket depth, PPD, width of keratinized gingival using Williams periodontal probe.
The parameters were recorded before & after the surgery. The surgical procedure was explained to the patients & informed consent was obtained.
Clinical examination
Case 1: A...