The use of locally delivered doxycycline may constitute an important adjunct for the active and supportive treatments of severe periodontal disease in smokers.

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Introduction: Orthodontic movement beyond the alveolar osseous limits may be associated with a greater tendency for developing severe gingival recession (GR), leading to esthetic compromise.Case Presentation: The purpose of this case report is to report the decision‐making process for the treatment of a challenging localized GR with root apex exposure caused by orthodontic movement; it was treated successfully after multidisciplinary approaches involving endodontic treatment, dental apicoectomy, and two periodontal mucogingival procedures, including a laterally positioned flap, subepithelial connective tissue, and bone grafts. The 2‐year follow‐up showed complete root coverage, long‐term stability of the gingival margin along with esthetic tissue contour and coloration, increased keratinized tissue, and complete filling of the bone depression.Conclusions: This case report serves as an example of how complex GRs caused by orthodontic movement may be resolved successfully by multidisciplinary approaches and using suitable root coverage techniques. The use of combined techniques in the present case report achieved complete root coverage and long‐term stability of the gingival margin and delivered the esthetics expected by the patient.