Recuperação dos tecidos da inserção supracrestal com retalho deslocado apicalmente associado a osteotomia: relato de caso

Resumo (EN)

To report a clinical case of supracrestal attachment tissues invasion area recovery with periodontal surgical technique of apically displaced flap associated with osteotomy. Methods – Clinically, element 34 presented carious lesion on the vestibular surface located more than 0,5 mm subgingival, and radiographically less than 3 mm from the bone crest, which characterized the invasion of the supracrestal attachment tissues. Flap surgery was indicated to change the position of the gingival tissue and remove bone tissue for its recovery. Presence of narrow gingival tissue width in the region determined the performance of the apically displaced flap technique, which includes sulcular and bilateral relaxing incisions. After osteotomy, which reestablished a 3 mm distance between the end of the cavity and the bone tissue, a provisional restoration was performed. In the postoperative period, chemical control of the supragingival biofilm was performed with 0,12% chlorhexidine digluconate and analgesic was prescribed. Results – After 7 days, the tissue appearance presented slight ulceration and bleeding, and supragingival biofilm mechanical control was reestablished. After 6 months postoperatively, the tissue appeared health, bleeding was absent, the concave arches contour was regular and the end of the provisional restoration remained exposed. Conclusions – In cases where there is supracrestal attachment tissue invasion and the gingival band is narrow, the apically displaced flap surgical technique with osteotomy was effective for its recovery and kept the end of the restoration exposed in the oral cavity.