Progressive Spacing of Incisors and Miller’s Class II Gingival Recession with Anterior Tongue Thrust Treated with Proper Alveolar Root Housing and Autogenously Gingival Grafting

Abstract

Amidst several controversies involving orthodontic treatment and gingival recession, periodontal complications of tongue thrust habit especially in adults have not yet been fully investigated. This case report presents a successful clinical case of progressive spacing of incisors (PSI) with gingival recession treated with proper alveolar root housing and autogenous grafting. A 24 year old girl reporting with mobility in mandibular anterior teeth was diagnosed Miller's class-II gingival recession of 7 mm and grade-II mobility in mandibular central incisors along with anterior tongue thrust habit. Spontaneous decrease in tooth mobility was achieved after correction of habit using fixed habit breaking appliance along with proper root positioning in the alveolar bone with fixed orthodontics. Post-debond, connective tissue gingival graft was performed using pouch and tunnel technique to achieve adequate root coverage. Thus interruption of tongue habit and correction of alveolar root housing is recommended for PSI with gingival recession.