title: The semilunar coronally repositioned flap combined with a frenectomy to obtain root coverage over the maxillary central incisors.
abstract: BACKGROUND
  This case report describes a method for coronally repositioning gingiva for root coverage over the maxillary central incisors while simultaneously performing a frenectomy.
  
  
  METHODS
  The patient was a healthy 43-year-old Brazilian female. Her chief complaint pertained to the unesthetic appearance of the gingival recession involving both maxillary central incisors. Intraoral examination revealed a thick biotype with an adequate band of keratinized gingiva, Miller Class I mucogingival defects, and a broad frenum extending beyond the mucogingival junction. The surgical technique used to treat the areas of recession involved making semilunar incisions over the maxillary central incisors that blended into a frenectomy.
  
  
  RESULTS
  Complete root coverage was achieved over the maxillary central incisors that initially presented with 2 mm of recession on the facial surface. The residual frenum no longer attached at a point coronal to the mucogingival margin. Small white scars were detectable at the mucogingival junctions above both incisors but were not an esthetic concern because of the patient's moderate smile line.
  
  
  CONCLUSIONS
  This case report shows the possibility of applying a combined semilunar coronally repositioned flap with a frenectomy in a case in which maxillary central incisors were impinged upon by a broad aberrant frenum, probed </=3 mm, and presented with Miller Class I mucogingival defects. Further controlled investigations are needed to define the efficacy of this surgical technique.
authors.affiliation: Ashman Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY, USA.
authors.forename: Jesse M
authors.initials: JM
authors.lastname: Sorrentino
authors.forename: Dennis P
authors.initials: DP
authors.lastname: Tarnow
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000637:transplantation*; D005889:Gingival Recession / Q000601:surgery*; D006801:Humans; D007180:Incisor / Q000601:surgery*; D007742:Labial Frenum / Q000601:surgery*; D008437:Maxilla / Q000601:surgery; D013524:Surgical Flaps; D014092:Tooth Root / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology