Prevention of Post-Gingivectomy Gingival Recession in Fixed Orthodontic Patients with Gingival Enlargement: A Case Report

Abstract

Background: The use of fixed orthodontic appliances can affect periodontal tissues. It can increase the risk of plaque and calculus accumulation. One of the effects on the periodontal tissue is gingival enlargement. The usual treatment for gingival enlargement is gingivectomy with an external bevel. This treatment carries a risk of gingival recession if the base of the pocket is apical to the cemento-enamel junction (CEJ).
 Objective: To report the actions to be taken in case of post-gingivectomy gingival recession.
 Case Report: An 18-year-old woman presented to the Dental and Oral Hospital, Universitas Gadjah Mada Prof. Soedomo, with complaints of swelling of the lower front gums, partially covering the crown of the teeth, sometimes bleeding when brushing her teeth, but no pain. The patient has been in fixed orthodontic treatment since early 2018. The treatment in this case in the form of gingivectomy gave good results which aimed to remove the gingival pocket, form a new gingival anatomy and create a new gingival margin. In addition, a new gingival margin was considered coronal with suturing and fixation on the brackets to prevent recession.
 Conclusion: The risk of gingival recession after gingivectomy can occur, especially in the gingiva with a thin biotype. Coronally advance flap may be an option to position the gingival margin coronal to the CEJ to prevent gingival recession after gingivectomy procedure.
 Keywords: gingival enlargement, gingivectomy, fixed orthodontic appliance, coronally advanced flap