Simultaneous Soft And Hard Tissue Augmentation On Periodontal Defects Tissues

This study aims to implement cortical bone osteotomy combined with simultaneous soft and hard tissue augmentation in adult orthodontic patients with soft and hard tissue defects. This study included patients who presented with bone dehiscence accompanied by gingival recession during orthodontic treatment. All patients underwent labial mucoperiosteal flap cortical osteotomy in the mandibular anterior region, with 0.5 g of Bio-Oss small particle bone graft material being implanted intraoperatively. Simultaneously, connective tissue grafting was performed on the teeth with gingival recession. The average root coverage ratio, the width of the keratinized gingiva, gingival recession depth and width, papilla height and width, and the cementoenamel junction (CEJ)-maximum root coverage distance were measured on 6 months postoperatively. Root coverage exceeded the level of the maximum root coverage line, with the gingival margin positioned 0.79±0.39 mm coronal to the maximum root coverage line (P<0.001). The average root coverage ratio was 76.43%±4.79%, and the complete root coverage rate was 29.40%. The root coverage aesthetic score was favorable, with a mean score of 7.65±0.39. No significant difference in osteogenic height was found between the labially inclined and lingually inclined groups (P>0.05). The increment of the keratinized gingival width was significantly negatively correlated with the preoperative keratinized gingival width (P=0.035). Cortical osteotomy combined with simultaneous soft and hard tissue augmentation can effectively improve periodontal soft and hard tissue defects.