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CASE OF THE MONTH. JANUARY 2012. HISTORY. 28 year-old male; m edical history within normal limits. 2- year history of periodic, progressive thermal hypersensitivity. Patient states progressive recession over the past year.

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case of the month

CASE OF THE MONTH

JANUARY 2012

history
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
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
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.
slide9

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
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.