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International Journal of Esthetic Dentistry  (English Edition)



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Int J Esthet Dent 11 (2016), No. 4     14. Oct. 2016
Int J Esthet Dent 11 (2016), No. 4  (14.10.2016)

Page 506-518, PubMed:27730221

Full-mouth treatment of gingival recessions and noncarious cervical lesions with coronally advanced flap and xenogeneic collagen matrix: a 2-year case report
Martiniello, Nello / Stefanini, Martina / Zucchelli, Giovanni
Background: In clinical practice it is common to observe adjacent multiple gingival recessions (MGRs) associated with noncarious cervical lesions (NCCLs). The aim of this 2-year case report was to describe the full-mouth treatment of a patient affected by MGRs and NCCLs, with a combined restorative-surgical approach using a coronally advanced flap (CAF) and a xenogeneic collagen matrix (CM).
Method: Before surgery, a composite restoration filled the deepest portion of the NCCL defects and was finished at the level of the maximum root coverage (MRC). The surgical technique adopted for the root coverage procedures was CAF for MGRs without vertical releasing incisions in the maxilla, and with one vertical releasing incision in the mandible. The CM was positioned at the level of the cementoenamel junction (CEJ), and sutured at the base of the anatomic de-epithelialized papillae. The flap was shifted coronally, providing complete coverage of the CM, and sutured coronal to the CEJ with a variable number of sling sutures.
Results: At 2 years, complete root coverage was achieved in all treated sites, and the patient reported complete resolution of dental hypersensitivity. In the questionnaire, the patient-reported outcome showed a high level of esthetic satisfaction (mean score: 9.6; range: 9 to 10), and the objective esthetic evaluation with the root coverage esthetic score (RES) system showed a very high result (mean: 9.4).
Conclusions: The suggested combined restorative-surgical approach provided successful root coverage and a favorable esthetic outcome in the treatment of MGR associated with NCCLs.