Int J Stomatol

Int J Stomatol ›› 2025, Vol. 52 ›› Issue (3): 323-332.doi: 10.7518/gjkq.2025039

• Periodontal cases • Previous Articles    

Vascularized interpositional periopel connective tissue flap combined with crown restoration for reconstruction of esthetic gingival papillae: a case report

Jieyu Zhou1(),Lei Zhao1,Yafei Wu1,Yong Li2,Huan Zhao1()   

  1. 1.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
    2.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics Ⅰ, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2024-03-16 Revised:2024-07-17 Online:2025-05-01 Published:2025-04-30
  • Contact: Huan Zhao E-mail:453499723@qq.com;cdzhaohuan@qq.com
  • Supported by:
    National Natural Science Foundation of China(82301089);Research and Develop Program, West China Hospital of Stomatology, Sichuan University(RD-02-202407)

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Abstract:

The “black triangle” formed by gingival recession and tooth displacement in the aesthetic area of anterior teeth due to periodontitis, local anatomical factors, mechanical injury, or abnormal occlusal force is a difficulty in oral clinical treatment. The vascularized interpositional periopel connective tissue (VIP-CT) flap is a connective tissue flap from the palate that has sufficient blood supply. It can promote bone graft osteogenesis and improve soft tissue defects in the labial and adjacent spaces. In this paper, we report a case of gingival recession in the aesthetic area with tooth displacement and absence of gingival papillae. The soft and hard tissue status was significantly improved after VIP-CT rotary flap transplantation and bone graft augmentation. This approach was combined with crown repair to restore the adjacent contact. The gingival papillae in the aesthetic area were effectively reconstructed, obtaining ideal aesthetic results.

Key words: gingival recession, papillary deficiency, black triangle, vascularized palatine periosteal connective tissue flap, prosthodontic treatment

CLC Number: 

  • R781.4

TrendMD: 

Fig 1

First visit: intraoral photographs"

Fig 2

First visit: periodontal chart"

Tab 1

First visit: PES scores of teeth 12, 11, 21, and 22"

PES参数12牙11牙21牙22牙
总分2167
近中龈乳头0112
远中龈乳头2022
龈缘顶点高度0000
龈缘曲线曲度0011
软组织丰满度/颜色/质地0022

Tab 2

First visit: WES scores of teeth 12, 11, 21, and 22"

WES参数12牙11牙21牙22牙
总分3366
牙冠形态0022
轮廓大小0011
牙冠颜色1111
表面纹理1111
透明度1111

Fig 3

First visit: X-rays"

Fig 4

First visit: CBCT images"

Fig 5

First visit: evaluation of periodontal prognosis"

Fig 6

The surgical procedure of bone augmentation and VIP-CT flap transplantation for teeth 11 and 12"

Fig 7

The intraoral photographs of teeth 11 and 12 VIP-CT flap transplantation and crown restoration"

Fig 8

The periodontal chart and periodontal risk assessment of 1 year after teeth 11 and 12 VIP-CT flap transplantation"

Fig 9

The X-ray of 1 year after teeth 11, 12 VIP-CT flap transplantation"

Fig 10

Comparison of preoperative and 1 year after prosthodontic treatment of teeth 12, 11"

Tab 3

Comparison of preoperative and 1 year after prosthodontic treatment of teeth 12, 11, 21, 22"

观察

时间

PES分值WES分值11、12牙间隙
12牙11牙21牙22牙12牙11牙21牙22牙PPIpCEJ-BC
治疗前2167336647 mm
治疗后10101010888813.7 mm
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