Surgical management of wide intrabony defect underlying midline diastema using Whale's tail flap technique: A Case Report

INTRODUCTION: Management of wide midline diastemas accompanying an underlying osseous defect is cumbersome which sometimes yields unpredictable results. However, regenerative therapy of these highly aesthetic zones using a Whale's tail flap technique obtains a maximum papilla fill after placement of the bone graft. This case report illustrated the utilisation of Whale's tail technique of flap for a large interdental defect.

CASE PRESENTATION: A young healthy 31-year-old male patient presented with maxillary midline diastema. Probing depth of 6 mm was also noted over the mesial aspect of the same teeth with localised osseous defect radiographically which lead to a diagnosis of localized chronic periodontitis in relation to those teeth. A Whale's tail technique flap for papilla preservation was performed together with a regenerative procedure using bone graft and GTR membrane.

DISCUSSION: Midline diastema is a common reported complaint in dentistry due to both aesthetic and functional reasons. Following the treatment, 12 months postoperatively, patient had a probing depth reduction of 3 mm and a gain in clinical attachment of 2 mm. The surgical technique allowed regeneration of wide intrabony defects involving the maxillary anterior teeth with notable interdental diastemas.

CONCLUSION: This lead to significant improvement of the hard and soft tissue contour as well as it recreated a functional reattachment which was documented up to 12 months postoperatively.