Periodontal-Orthodontic Combined Therapy For Mandibular Anterior Gingival Recession

A case of gingival recession and labial bone augmentation in mandibular anterior teeth under combined periodontal-orthodontic treatment. The patient is a 36-year-old male with gingival recession in the mandibular anterior teeth for 10 years. Clinical examination revealed lingually inclined Class III deep overbite.#31 exhibited 6 mm of gingival recession with 5 mm Probing Depth (PD), while #41 showed 3 mm recession and 3 mm PD, and severe labial alveolar bone deficiency. A multidisciplinary treatment plan was formulated under combined periodontal-orthodontic consultation: (1) Periodontal initial therapy. (2) Orthodontic intervention for bite opening and malocclusion correction. (3) Mucogingival surgery for root coverage. (4) Guided bone regeneration (GBR) to be performed as needed. The condition improved after 18 months, with #31 gingival recession from 6 mm to 0 mm and PD from 5mm to 1 mm, #41 gingival recession from 3 mm to 0 mm and PD from 3mm to 1 mm. The anterior overbite was corrected to Class II, labial bone significantly augmented by GBR after 1 year. Plaque accumulation, occlusal trauma, and labial bone deficiency were the primary etiological factors. The laterally positioned flap was the optimal surgical choice foradequate gingival thickness and narrow recession defect. The periodontal-orthodontic treatment effectively improved occlusion, controlled inflammation, and enhanced soft/hard tissue reconstruction. Regular periodontal maintenance ensured long-term stability. Combined periodontal-orthodontic treatment effectively addresses the deficiency of both soft and hard tissues in anterior region.