Periosteum as a lateral pedicle graft for the treatment of single tooth root recession: A novel approach

Abstract

The treatment of gingival recession defects is indicated for esthetic and functional reasons to reduce root sensitivity, to remove muscle pull, to create or augment keratinized tissue, and to prevent disease progression. The presence of sufficient amount of periosteum adjacent to gingival recession defects makes it a suitable graft. The adult human periosteum is a highly vascular connective tissue with immense regenerative potential. It contains fibroblasts, osteogenic progenitor cells, and stem cells as a result of which it has the ability to differentiate into fibroblast, osteoblast, chondrocytes, adipocytes, and skeletal myocytes. The tissue provided by these cells includes cementum with periodontal ligament fibers and bone. Therefore, in the present case, periosteum has been used as a lateral pedicle graft for the coverage of the single tooth gingival recession (mandibular central incisor). The procedure is justified by the evidence that periosteum is capable of proliferation and osteogenesis after injury.

Keywords: Gingival recession; Lateral pedicle graft; Periosteum.

Fig. 1

Preoperative.

Fig. 2

IOPA X-ray.

Fig. 3

Recipient bed.

Fig. 4

Partial thickness flap reflected.

Fig. 5

Periosteum reflected.

Fig. 6

Periosteum covering recession and sutured.

Fig. 7

Partial thickness flap at its original position and sutured.

Fig. 8

Periodontal dressing placed.

Fig. 9

1 week postoperative.

Fig. 10

1 month postoperative.

Fig. 11

3 month postoperative.

Fig. 12

6 month postoperative.