Gingival recession (GR) is defined as a pathological

migration of the gingival margin apically to the cemento-

enamel junction leading to root exposure. It has a

wide multifactorial etiology including anatomical and

mechanical factors such as thin gingival phenotype,

compromised attached gingival width, suboptimal tooth

positioning and the influence of labial muscle tension.

This case report discusses an 18-year-old female patient

presenting with gingivitis, suboptimal oral hygiene,

lower anterior gingival recession, and a thin gingival

phenotype. The patient also exhibited misalignment of

anterior teeth, with orthodontic treatment planned to

correct this issue, which could potentially exacerbate the

gingival recession due to the anticipated tooth movement.

Upon completion of non-surgical periodontal

treatment (NSPT) and establishment of optimal oral

hygiene, a free gingival graft surgery was planned for the

lower anterior incisor area. The primary objectives were

to increase the width of attached gingiva, enhance tissue

thickness, and provide a more resilient gingival margin.

During the procedure, special care was put into carefully

detaching muscular attachments to decrease muscular

tension on the gingival margin and increase vestibular depth.

Postoperative results were highly favorable, with a

significant increase in the width of the attached gingiva

and successful rehabilitation of the gingival recession.

The surgical intervention stabilized the gingival margin

and enabled better access to the lower incisor area, in

terms of oral hygiene performance. This case highlights

the importance of addressing mucogingival deficiencies

before initiating orthodontic treatment to ensure long-term

success.