Dual root coverage of severely traumatized maxillary central incisors: a divided soft tissue management approach

A dual mucogingival treatment is presented in which severely traumatized maxillary central incisors sustained lateral and extrusive luxation injuries in a roadside accident. Injuries resulted in complete loss of the overlying radicular labial cortical plate followed by a gingival soft tissue cleft, which created a Grade II Miller recession defect in relation to the labial aspect of the maxillary central incisors. A multidisciplinary treatment approach was used, including emergency care, endodontic therapy, and sequential dual periodontal soft tissue rehabilitation. Subepithelial connective tissue grafting was carried out using two techniques, which proved successful in achieving complete coverage of the defect sites. This two-stage surgical approach enabled achievement of ample vascularization for soft tissue grafting and enhanced its predictability for optimal outcome. At the 3-year follow-up, clinical and radiographic examination showed a maintainable functional and esthetic status.