Treatment of adjacent gingival recessions with subepithelial connective tissue grafts and the modified tunnel technique.
OBJECTIVE
There has been great interest in the treatment of gingival recession defects, especially with subepithelial connective tissue grafting. Recent advances have focused on subepithelial connective tissue grafting by the tunnel technique. In this clinical study, a modified periodontal plastic surgery technique for coverage of adjacent gingival recessions was performed. This surgical modification was based on the tunnel technique without vertical incisions, where the partial dissection was converted to a full-thickness dissection at the mucogingival area to supply more blood vessels.


METHODS
Patients, each contributing at least two adjacent buccal gingival recessions, were treated. Subepithelial connective tissue grafting was used to cover the defects. Gingival recession, probing depth, and attachment level were measured at baseline and 8 months posttreatment.


RESULTS
There were statistically significant improvements in attachment level and gingival recession after 8 months; the mean gain in attachment was 3.67 mm and the mean root coverage was 3.28 mm, which translated to mean root coverage of 95%.


CONCLUSIONS
These findings suggest that subepithelial connective tissue grafting with a modified tunnel approach, in which the partial-thickness flap is converted to a full-thickness flap in a coronoapical direction, results in adequate early healing and highly predictable root coverage in adjacent gingival recessions.
Tözüm
Tolga F
TF
Department of Periodontology, Faculty of Dentistry, Hacettepe University, Sihhiye, Ankara, Turkey. ttozum@hacettepe.edu.tr
Dini
Farid M
FM
D003238:Connective Tissue / Q000473:pathology / Q000637:transplantation; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology / Q000637:transplantation*; D005889:Gingival Recession / Q000473:pathology / Q000601:surgery*; D005893:Gingivoplasty / Q000379:methods; D006085:Graft Survival; D006801:Humans; D017622:Periodontal Attachment Loss / Q000473:pathology / Q000601:surgery; D010514:Periodontal Pocket / Q000473:pathology / Q000601:surgery; D013524:Surgical Flaps / Q000473:pathology; D014092:Tooth Root / Q000473:pathology