Gingival Recession Treated with Minimally Invasive Pinhole Surgery

• Name – Mr. Abhinandan Khajuria
• Age – 23 years
• Gender – Male

The patient had a significant dissatisfaction with the aesthetics due to the apical migration of the gingival tissue margins in the lower arch.

Dr. Rajat Sachdeva MDS, MS, Implantologist at Dr. Sachdeva’s Dental Aesthetic and Implant Center, Delhi.

Gingival recession is a condition that affects practically many in their middle and older age. The apical migration of the gingival margin to the cementoenamel junction (CEJ) is known as a gingival recession. The amount of recession is determined by the distance between the CEJ and the gingival margin.

Periodontal disease, accumulations, inflammation, inappropriate flossing, vigorous brushing, wrong occlusal connections, and dominating roots can all cause gingival recession. Gingival recession can be either localized or generalized. Recession can happen with or without associated tissue loss.

Because of the exposed dentin, gingival recession can produce increased sensitivity. Compared to adjacent teeth, it can be identified by the appearance of a lengthy clinical tooth and a varying fraction of the teeth.

Mr. Abhinandan Khajuria, a patient, reported at our dental clinic in Ashok Vihar, Delhi, with a significant dissatisfaction with the aesthetics due to the apical migration of the gingival tissue margins in the lower arch.

Dr. Rajat Sachdeva, a renowned dental specialist in Ashok Vihar, Delhi, examined the patient. The detailed clinical examination revealed Miller’s one recession of 3mm with 31 and 1 mm with 41. No periodontal pockets were found, and all teeth were vital and stable.

The patient was informed about the clinical conditions and the minimally invasive Pinhole surgical technique (scalpel free, suture-free procedure) for root coverage in this particular case. The surgical procedure was well explained to the patient, and informed consent was obtained.

• Initially, Dr. Sachdeva carried the therapy of scaling and root planning with ultrasonic scalers. Then, he administered the local anaesthesia (lignocaine 1:80000) to the patient at the surgical site.
• Further, Dr. Sachdeva made a pinhole incision with an orbans knife in the alveolar mucosa of the centremost teeth with recession to elevate the mucosal tissue in the apicocoronally direction.
• Access was gained through the pinhole created using gingival elevators.
• Next, Dr. Sachdeva removed the muscular and fibrous adhesions with special perio instruments through the pinhole.
• Supra periosteal closed blunt dissection was done apicocoronally and laterally till interdental papillae.
• The advanced tissue was stabilized using the membrane were inserted in the pinhole and positioned at interdental papillae achieving a sufficient fullness in the papillary tissues for holding the mucogingival tissue complex.
• No incisions were placed anywhere, and no requirement for sutures.
• Dr. Sachdeva covered the site operated with a coe-pak.
• The complete mucogingival complex was moved coronally by the fullness of the tissues with the minimally invasive approach, and the patient was able to see the gingival coverage immediately.

Dr. Sachdeva advised the patient to take analgesics and asked to discontinue if the pain subsides.

• Dr. Sachdeva advised the patient to apply an ice pack in intervals for 24 hours.
• Advised rinses with 0.2% chlorhexidine gluconate mouthwash for three weeks.
• Dr. Sachdeva asked the patient for re-evaluation after seven days.

This is what the patient, Mr. Abhinandan Khajuria said about his dental treatment: “I was dissatisfied with my previous aesthetics. Now, I am pleased with the treatment results. Thanks to Dr. Rajat Sachdeva and his dedicated team.