Abstract：
This report describes a case of gingival recession in multiple teeth with severe dentin hypersensitivity (DH) in which treatment included periodontal plastic surgery. The patient was a 34-year-old woman presenting with the chief complaint of DH at gingivalrecession sites. The patient had undergone orthodontic treatment when she was 30 years old. An initial examination revealed that none of the sites showed a probing depth of ≥4 mm and 21% of sites bleeding on probing. The clinical diagnosis was plaque-induced gingivitis. Teeth #14, 16, 23, 25, 26, 34, 35, 45, and 46 showed gingival recession ranging from 1 to 4 mm. Gingival recession at #45 extended to the muco-gingival junction. No association with alveolar bone loss was observed in any of the interdental areas. Therefore, the sites presenting with gingival recession were classified as Miller Class I, except #45, which was classified as Class II. The periodontal phenotype was \'thin\'. Based on the results of clinical examination and diagnosis, initial periodontal therapy (IP) consisting of oral hygiene instruction, supra-gingival scaling, application of a desensitizing agent, and composite resin restoration was performed. The Visual Analog Scale (VAS) score, which was used to assess degree of DH, showed only a minimal decrease, however, at post-IP. Subsequently, a modified coronally advanced tunnel (a modified technique for achieving a coronally advanced flap) using a connective tissue graft was performed in #14, 16, 23, 25, 26, 45, and 46. After re-evaluation, the patient was placed on maintenance care. The series of interventions resulted in a considerable improvement in the VAS and oral health-related quality of life scores. Furthermore, a change in the periodontal phenotype, from \'thin\' to \'thick\', was observed, which may contribute to the prevention of further gingival recession and DH. The present case suggests that periodontal plastic surgery is an effective treatment modality for the resolution of DH.
摘要：
该报告描述了一例严重牙本质过敏症（DH）的多颗牙齿牙龈退缩的情况，其中治疗包括牙周整形手术。该患者是一名34岁的妇女，在牙龈衰退部位提出DH的主要投诉。该患者在30岁时接受了正畸治疗。初步检查显示，没有一个部位的探测深度≥4mm，有21％的部位在探测时出血。临床诊断为菌斑性牙龈炎。牙齿＃14、16、23、25、26、34、35、45和46显示出范围为1至4毫米的牙龈衰退。＃45处的牙龈衰退延伸到粘膜-牙龈交界处。在任何齿间区域均未观察到与牙槽骨丢失的关联。因此,出现牙龈衰退的地点被归类为米勒一级，除了#45，它被归类为II类。牙周表型为“瘦”。根据临床检查和诊断结果，初始牙周治疗（IP），包括口腔卫生指导，牙龈上除鳞，脱敏剂的应用，并进行了复合树脂修复。视觉模拟量表(VAS)评分,用于评估DH的程度，只显示最小的下降，然而,在后IP。随后，在#14,16,23,25,26,45和46中使用结缔组织移植物进行了改良的冠状推进隧道(用于实现冠状推进皮瓣的改良技术).重新评估后,患者接受了维持护理.一系列干预措施使VAS和与口腔健康相关的生活质量评分得到了显着改善。此外，牙周表型的变化，从“薄”到“厚”，被观察到,这可能有助于预防进一步的牙龈衰退和DH。目前的情况表明，牙周整形手术是解决DH的有效治疗方式。
