Parallelling Technique for Frenectomy to Prevent Black Triangle in Pre-Orthodontic Patients: A Case Report

Background: Gingival recession can cause esthetic problems, especially if it occurs in the maxillary anterior region. Gingival recession accompanied by endodontic complications requires a multidisciplinary approach to achieve successful therapy. Objective: To report the treatment of Miller’s class-III gingival recession using laterally stretched flap + connective tissue graft with frenotomy and apicoectomy in one visit. Case Report: A healthy 24-year-old man presented with chief complaints of open and painful gums on his left upper front tooth. After objective and radiographic examinations, the diagnosis of tooth 21 was Miller’s class-III gingival recession, that is, plaque and calculus with endo–perio lesions and grade 1 luxation. The treatment given included scaling, root planning, curettage, retreatment of root canal and root coverage therapy with frenotomy and apicoectomy. Results: The results obtained were partial root coverage of 71.4% and an increase in the thickness of keratinized tissue. Conclusion: Healing of periodontal tissue damage accompanied by endodontic lesions showed success and obtained stable treatment results with a multidisciplinary approach. Keywords: Miller’s class-III gingival recession, endodontic lesion, laterally stretched flap, apicoectom