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Considerations for Selecting Root Coverage Techniques in the Anterior Mandible.

Hamoun Sabri, Shayan Barootchi, Allan J Padbury

    The International Journal of Periodontics & Restorative Dentistry
    |October 11, 2023
    PubMed
    Summary

    Periodontal plastic surgery in the anterior mandible is challenging. This study reviews techniques like coronally advanced flaps and provides a decision table for optimal root coverage and esthetic outcomes.

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    Area of Science:

    • Periodontal Plastic Surgery
    • Regenerative Dentistry
    • Oral and Maxillofacial Surgery

    Background:

    • The anterior mandible presents unique challenges for periodontal plastic surgery due to esthetic demands and the need for root coverage.
    • Pedicle flap-based techniques are increasingly favored over free gingival grafts for superior outcomes in this region.
    • Optimizing root coverage and esthetics in the anterior mandible requires careful selection of surgical approaches.

    Purpose of the Study:

    • To systematically review current literature on periodontal plastic surgery techniques for the anterior mandible.
    • To identify the most frequently used techniques, their indications, and reported efficacy.
    • To develop a decision-making table to guide surgeons in selecting appropriate techniques for root coverage.

    Main Methods:

    • Comprehensive literature search to identify relevant studies on periodontal plastic surgery in the anterior mandible.
    • Analysis of identified techniques, including free gingival graft, lateral sliding flap, tunneling, and coronally advanced flap.
    • Development of a decision table incorporating patient chief complaint, local anatomy, and technique sensitivity.

    Main Results:

    • Four primary surgical approaches were identified: free gingival graft, lateral sliding flap, tunneling, and coronally advanced flap.
    • Flap-based techniques are frequently augmented with connective tissue grafts for enhanced results.
    • The proposed decision table offers a framework for evidence-based technique selection.

    Conclusions:

    • The anterior mandible requires specialized surgical strategies for successful periodontal plastic surgery.
    • A decision table can aid surgeons in choosing the most suitable technique for predictable root coverage and esthetic outcomes.
    • Further research into novel methods for anterior mandibular root coverage is warranted.