CASE OF THE MONTH JANUARY 2012
HISTORY • 28 year-old male; medical history within normal limits. • 2- year history of periodic, progressive thermal hypersensitivity. Patient states progressive recession over the past year. • Referral to periodontist for evaluation and potential treatment.
CLINICAL EXAM • Teeth #9 through #11 revealed dentinal exposure, ranging from 2-4 mm. • Recession is classified Miller’s Class I • No bleeding upon probing, and probing depths were less than 3 mm. • No perceptible tooth mobility was noted. • Radiographs presented no evidence of interproximal bone loss. • No history of tobacco use.
TREATMENT PLAN • Discussion of current plaque control regimen. Patient currently uses “medium” stiffness toothbrush. The patient will convert to toothbrush of “soft” stiffness. • Treatment options proposed to patient: • Autogenous soft tissue • Acellular dermal matrix (ADM) • Patient selects ADM due to concern for second surgical site.
The following slide shows closure of the site and coverage of the ADM via expanded polytetrafluorethylene sutures (e-PTFE). • Individual sling sutures were placed, and tied on the palatal surfaces of the respective teeth.
SUMMARY • PROBLEM • Periodic, progressive thermal hypersensitivity in areas of dentinal exposure. • TREATMENT • Use of Acellular Dermal Matrix as graft material in a root coverage procedure. • OUTCOME • 1 to 3 mm probing depths, with total root coverage, and no thermal hypersensitivity at 21 months post-surgery.