Human and animal studies suggest that the thickness of the marginal tissue is a determinant of susceptibility to gingival recession during facial tooth movement. When thin facial marginal tissues are inflamed, there is even greater concern about the risk of attachment loss during orthodontic treatment. This report describes a case where a subepithelial acellular dermal matrix allograft was used to augment the thickness of gingival tissue and the zone of attached gingiva overlying prominent mandibular incisor roots prior to orthodontic treatment of a young patient. Use of an allograft shortened the procedure time and eliminated the need for palatal donor sites. The graft enhanced the tissue thickness facial to the mandibular anterior teeth and produced relatively little post-operative discomfort. Although plaque-induced inflammation developed around the mandibular anterior teeth during orthodontic treatment, there was no loss of attachment.
Keywords: gingival graft, gingival recession, gingivitis