Beyond the traditional monotherapy of connective tissue grafting, the combination of orthodontic therapy, soft-tissue grafting, and bone grafting with biologics may provide ideal treatment for complex recession defects with root prominence, thin tissues, and buccal plate dehiscences. The authors propose the benefits of performing a preoperative evaluation of complex mucogingival defects with cone-beam computed tomography (CBCT) technology and then considering surgical management with modalities like bone grafting and orthodontics in addition to the classic soft-tissue grafting approach. Regeneration of the complete periodontium may result in better long-term soft-tissue stability and tooth retention following treatment of complex recession cases.
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