A patient taking bisphosphonates presents with localized gingival recession on a single tooth. What is the MOST appropriate management?

Correct answer: C. Free gingival graft to cover the recession

• A. A dental implant would require extraction (bone trauma) — highly contraindicated in bisphosphonate patients due to BRONJ risk.
• B. A Class V composite restoration addresses the exposed root's cervical surface to prevent caries/sensitivity but does not treat the recession or increase attached gingiva.
• C. CORRECT. For a patient on bisphosphonates with recession, a free gingival graft (or connective tissue graft) is the most appropriate treatment to cover the recession and provide adequate attached gingiva. However, the dentist must be aware of the osteonecrosis risk with bisphosphonates if the surgical procedure involves the alveolar bone. Soft tissue grafts that do not involve bone manipulation are generally considered safer.
• D. Monitoring alone is appropriate only if the recession is stable and the patient is asymptomatic. If progressive, active management is warranted.