Mucogingival Surgery and Esthetic Periodontics
What this domain tests
Gingival recession, root coverage, keratinized tissue, and esthetic crown lengthening. Questions test classification, technique selection, and predictability.
Classification and rules
- Miller I–IV describes recession and interdental loss. Cairo RT1 has no interproximal attachment loss, RT2 has interproximal loss less than or equal to buccal loss, and RT3 has interproximal loss greater than buccal loss.
- Root coverage is predictable in RT1 and RT2; RT3 is generally not fully coverable.
- Connective tissue graft plus coronally advanced flap is the reference standard for RT1 defects.
- Free gingival graft increases keratinized tissue but gives poorer color match; it is useful when keratinized tissue is the priority.
- Tunnel technique preserves the papilla and blood supply; it demands careful case selection.
- Crown lengthening must respect supracrestal attached tissues and the smile line.
Worked example
A 32-year-old has a 3-mm RT1 recession on the maxillary canine, 1 mm of attached gingiva, thin biotype, and no interproximal loss. CAF plus CTG is chosen because it offers the best evidence for complete root coverage and gains keratinized tissue. A free gingival graft would be chosen if the priority were increasing keratinized tissue rather than esthetics.
Traps
- Using Miller classification and Cairo classification interchangeably.
- Expecting complete coverage in RT3.
- Ignoring the biotype and papilla height.
- Performing crown lengthening without considering biologic width and esthetic risk.