The Treatment of Gingival Recession Associated with Deep Corono-Radicular Abrasions (CEJ step) – a Case Series

Cervical dental caries and/or abrasions are often associated with gingival recessions. These lesions can be treated with either restorative or periodontal approaches. There are various periodontal approaches for treating gingival recessions associated with carious cervical lesions (Matter, 1979; Fourel, 1982; Miller, 1983; Pini Prato et al, 1992; Goldstein et al, 2002) that make it possible to achieve excellent clinical results both in terms of root coverage and cosmetic effects. The literature, however, contains little information on periodontal treatment of gingival recessions associated with cervical dental lesions. The abrasions can involve the root, with deep steps at the cemento-enamel junction, or both the root cementum and the enamel. In this latter situation there are often marked steps at the CEJ level (Fig. 1). This is often associated with dental hypersensitivity which, along with cosmetic problems, is an indication for mucogingival surgery for root coverage (Wennström 1993, 1996). When using the surgical approach, the periodontist generally grinds the abrasion, eliminating sharp edges and planes the CEJ in order to position the flap and/or graft, with maximum adaptability to the tooth surface preventing dead tracts underneath (Holbrook and Ochsenbein, 1983). In any event, if the root coverage after treatment is incomplete, grinding the abrasion or planning the CEJ can lead to increased hypersensitivity. In order to prevent this further hypersensitivity and to avoid unnecessary removal of dental tissue, especially in patients who do not present initial dental hypersensitivity, it may be appropriate not to use mechanical techniques such as grinding on the abrasion or CEJ prior to mucogingival surgery for root coverage. Bilaminar techniques have contributed to better prognoses in the treatment of gingival recessions. Furthermore, recent studies have reported the importance of some factors related to the surgical technique that are useful for achieving a better percentage of root coverage. In particular, the pedicle flaps used to cover the connective tissue The Treatment of Gingival Recession Associated with Deep Corono-Radicular Abrasions (CEJ step) – a Case Series