Looking for advise on simultaneously grafting tooth 31 and a lower labial frenectomy. How would this treatment be completed in a single visit? Patient is aware of the existing recession on the other dentition but wished to have tooth 31 grafted in order for the gingiva to be more symmetrical. Sorry, no radiographs available at this time. Thanks!
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This patient has significant horizontal bone loss due to chronic periodontitis. The recession is a consequence of periodontal disease and not the consequence of aggressive brushing, a thin tissue biotype, or orthodontics. Since the interproximal bone loss is significant, you will not be able to achieve root coverage in this case. If the patient’s chief concerns is root coverage to make the two teeth more symmetrical in appearance, then is not likely that you will be able to achieve this objective. If there is discomfort on chewing due to a mucogingival defect then soft tissue graft and frenectomy could improve the tissue biotype and improve comfort although no root coverage is expected. Also note that the progressive nature of chronic periodontitis has to be disclosed to the patient so that he has realistic expectations as to the purpose and longevity of any soft tissue grafting procedure. Bassel Gebrael DDS