title: Root coverage with a modified laterally positioned flap combined with a subepithelial connective tissue graft in advanced recession.
abstract: OBJECTIVE
  A laterally positioned flap (LPF) combined with a subepithelial connective tissue graft (SCTG) is one of the conventional approaches for resolving gingival recession defects, with the advantages of flap flexibility and extended coverage of the tissue graft. However, thus far, evidence is lacking for the use of this technique for the treatment of advanced gingival recession defects. This report discusses three Miller class III cases with interproximal bone loss and wide and deep defects treated with a combination procedure of a modified laterally positioned flap (mLPF) and SCTG.
  
  
  METHODS
  mLPF combined with SCTG was performed for each case. The defect size and the degree of hypersensitivity at baseline and the final appointment in each case were documented.
  
  
  RESULTS
  The three cases had a mean initial defect of 7.7±1.5 mm and a mean residual defect of 1.7±1 mm at the 6-, 3-, and 36-month follow-up, respectively, after the root coverage surgery. The symptom of hypersensitivity was improved, and the patients were satisfied with the clinical outcomes.
  
  
  CONCLUSIONS
  The results demonstrated that the combination of mLPF with SCTG is promising for treating these advanced cases with respect to obtaining the expected root coverage with the gingival tissue.
authors.affiliation: Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
authors.forename: Chun-Teh
authors.identifier: 0000-0001-7812-5637
authors.initials: CT
authors.lastname: Lee
authors.affiliation: Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.
authors.forename: Po-Chun
authors.identifier: 0000-0002-4493-6922
authors.initials: PC
authors.lastname: Chang
authors.affiliation: Private Practice, Ottawa, ON, Canada.
authors.forename: Nawar
authors.identifier: 0000-0002-6390-5793
authors.initials: N
authors.lastname: Touchan
authors.affiliation: Division of Periodontics, Section of Oral and Diagnostic Sciences, College of Dental Medicine, Columbia University, New York, NY, USA.
authors.forename: Daniel
authors.identifier: 0000-0002-0079-7676
authors.initials: D
authors.lastname: Royzman
keywords: Case reports; Gingival recession; Periodontics