Corticotomy-assisted autogenous bone grafting for management of buccal bone dehiscence and gingival recession: A case report

Class III malocclusion correction carries a risk of periodontal complications, including gingival recession and alveolar bone defects. Cone-beam computed tomography (CBCT) improves diagnostic accuracy, and bone augmentation techniques offer a potential solution. This study investigated a surgical intervention designed to prevent buccal plate damage to mandibular incisors during orthodontic treatment.

An 18-year-old female presented with localized gingival recession at tooth #24 following incomplete orthodontic treatment. CBCT revealed significant buccal plate bone loss, compromising the orthodontic therapy. An autogenous bone graft was harvested from the mental symphysis and secured using corticotomy-assisted stabilization. The surgical protocol included meticulous flap elevation, graft placement, and tension-free closure. Postoperative CBCT at 3 months demonstrated marked improvement in bone dimensions, with no complications reported.

The case underscores the multifactorial etiology of buccal bone loss, including thin alveolar bone, orthodontic tooth movement, and pre-existing anatomical vulnerabilities. The use of corticotomy for graft stabilization avoided the risks associated with screw fixation promoting vascularization and graft integration. This approach aligns with evidence supporting corticotomy and guided bone regeneration (GBR) for preserving periodontal health during complex orthodontic movements.

Augmented corticotomy with autogenous bone grafting is an effective strategy for managing buccal bone defects in high-risk orthodontic cases. This technique not only restores bone volume but also minimizes complications associated with traditional fixation methods. Early diagnosis and interdisciplinary collaboration are essential to optimize outcomes in patients with predisposing factors for gingival recession and bone loss.