State of the art of mucogingival surgery for the coverage of deep gingival recessions in anterior areas
Treatment of gingival recession has become an important therapeutic issue due to the increasing number of cosmetic request from patients. Patients aesthetic demand, due to the exposure, during smiling or function, of portions of the root surface, is the main indication for root coverage surgical procedures. Very often the most coronal millimeter/s of the root exposure is the only visible part of the recession when smiling, therefore the presence and/or the persistence after therapy, even of a shallow recession may be an aesthetic problem for the patient. Thus, complete root coverage, up to the cemento-enamel junction, is the goal to be achieved when patient complains about the aesthetic appearance of his/her teeth. Another factor to be considered is most frequently gingival recessions affect group of adjacent teeth In order to minimize the number of surgeries and to optimize the aesthetic result, all the contiguous recessions should be treated at the same surgical time. A new approach of the coronally advanced flap with minimally invasive connective tissue grafts has been used to treat multiple recession defects affecting adjacent teeth in patients with aesthetic demands. This surgical technique has been demonstrated to achieve complete root coverage in all treated recessions in most of the patients irrespective to the number of recessions treated in each intervention. These outcomes can be long term maintained.