case_images: PMC6374862_01
case_images: Patient #1: tooth UL1 presents an anaesthetic discoloration, cervical abrasion, thin gingival biotype, and free gingival margin discrepancy compared to the contralateral tooth.
case_images: CRID2019-5828423.001.jpg
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case_images: fig1
case_images: Moreover, UL1 has been previously endodontically treated with an esthetical defect due to discoloration and radicular abrasion, having a buccal gingival margin almost 3 mm more apical than the contralateral (REC 3 mm), a 3 mm PD and showing a medium biotype (Figure 1).
case_images: Patient #2: a buccal gingival recession of more than 2 mm is noticed in correspondence with UL3.
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case_images: fig2
case_images: REC was 4 mm, PD was 2 mm, and a gingival biotype was detailed as a medium (Figure 2).
case_images: PMC6374862_02
case_images: Central incisor was endodontically treated, restored with a composite post, and prosthetically prepared with a vertical finishing line.
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case_images: fig3
case_images: The tooth had vertical preparation, and temporary crown margins were adapted at first at the free gingival margin position (Figures 3 and 4).
case_images: Temporary crown was delivered, and its cervical margin was located at the free gingival baseline position.
case_images: CRID2019-5828423.004.jpg
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case_images: fig4
case_images: The tooth had vertical preparation, and temporary crown margins were adapted at first at the free gingival margin position (Figures 3 and 4).
case_images: Temporary crown margin was 2 mm shortened.
case_images: CRID2019-5828423.005.jpg
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case_images: fig5
case_images: The temporary crown buccal margin was 2 mm shortened, and the gingival epithelial components (sulcus and the upper part of the junctional epithelium) were gently disephitelized with a diamond flame bur (120-micron granulometry) and the root surface exposed to the oral environment planed and smoothed with manual curettes and washed with saline solution (Figures 5 and 6).
case_images: With diamond bur sulcus, junctional epithelium was gently removed, thus creating an induced inflammation.
case_images: CRID2019-5828423.006.jpg
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case_images: fig6
case_images: The temporary crown buccal margin was 2 mm shortened, and the gingival epithelial components (sulcus and the upper part of the junctional epithelium) were gently disephitelized with a diamond flame bur (120-micron granulometry) and the root surface exposed to the oral environment planed and smoothed with manual curettes and washed with saline solution (Figures 5 and 6).
case_images: After 6 weeks, free gingival margin appeared thicker and an initial creeping can be noticed.
case_images: CRID2019-5828423.007.jpg
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case_images: fig7
case_images: After 6 months, the gingival margin reached the temporary crown (Figure 7).
case_images: Temporary crown cervical margin was reshaped, mirroring the contralateral, and "stimulation" was performed again.
case_images: CRID2019-5828423.008.jpg
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case_images: fig8
case_images: Her buccal margin was shortened and aligned to the contralateral CEJ level, and the gingival margin was stimulated as before with the same postop chemical plaque control (Figure 8).
case_images: 10 month picture: central incisors free gingival margin was at the same level; creeping occurred on UL1, with the thickening of the biotype.
case_images: CRID2019-5828423.009.jpg
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case_images: fig9
case_images: Impressions were taken and a zirconia-ceramic definitive crown was cemented to the tooth (Figure 9).
case_images: A definitive zirconia-ceramic crown was cemented (note the scalloped gingival architecture without scars or color mismatching). Control at 24 months of follow-up.
case_images: CRID2019-5828423.010.jpg
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case_images: fig10
case_images: Results were stable at the 2-year follow-up (Figures 10 and 15).
case_images: PMC6374862_03
case_images: Radicular exposed surface was manually cleaned, and gingival epithelial components adjacent to the tooth were gently removed with a diamond bur.
case_images: CRID2019-5828423.011.jpg
case_images: PMC6374862_03_CRID2019-5828423.011.jpg
case_images: fig11
case_images: Using the same previous reported protocol, dental sulcus and coronal portion of the junctional epithelium were disephitelized with a diamond flame bur (120-micron granulometry), and the radicular surface was planed and smoothed with a manual curette (Figures 11 and 12).
case_images: Marginal bleeding occurred with blood clot formation and stabilization.
case_images: CRID2019-5828423.012.jpg
case_images: PMC6374862_03_CRID2019-5828423.012.jpg
case_images: fig12
case_images: Using the same previous reported protocol, dental sulcus and coronal portion of the junctional epithelium were disephitelized with a diamond flame bur (120-micron granulometry), and the radicular surface was planed and smoothed with a manual curette (Figures 11 and 12).
case_images: Gingival margin was thicker and again stimulated with the same protocol (4 weeks of follow-up).
case_images: CRID2019-5828423.013.jpg
case_images: PMC6374862_03_CRID2019-5828423.013.jpg
case_images: fig13
case_images: In this second appointment, after local anaesthesia, the gingival margin was again stimulated as described before (Figure 13).
case_images: Complete root coverage was achieved by means of an induced creeping attachment at 6 months of follow-up; no scars and no tissue blending could be appreciated.
case_images: CRID2019-5828423.014.jpg
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case_images: fig14
case_images: After 6 months, root coverage was reached, with a thick gingival margin and no pathological probing or inflammation (Figure 14).
case_images: PMC6374862_04
case_images: A definitive zirconia-ceramic crown was cemented (note the scalloped gingival architecture without scars or color mismatching). Control at 24 months of follow-up.
case_images: CRID2019-5828423.010.jpg
case_images: PMC6374862_04_CRID2019-5828423.010.jpg
case_images: fig10
case_images: Results were stable at the 2-year follow-up (Figures 10 and 15).
case_images: Stability of the root coverage on UL3 after 24 months.
case_images: CRID2019-5828423.015.jpg
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case_images: fig15
case_images: Results were stable at the 2-year follow-up (Figures 10 and 15).