title: Treatment of multiple adjacent maxillary Miller Class I, II, and III gingival recessions with the modified coronally advanced tunnel, enamel matrix derivative, and subepithelial connective tissue graft: A report of 12 cases.
abstract: OBJECTIVE
  To clinically evaluate the healing of multiple adjacent maxillary Miller Class I, II, and III gingival recessions (MAGR) treated with the modified coronally advanced tunnel (MCAT) in conjunction with an enamel matrix derivative (EMD) and subepithelial connective tissue graft (SCTG).
  
  
  METHODS
  Twelve systemically healthy patients (6 females) with a total of 54 adjacent maxillary Miller Class I, II, or III MAGR were consecutively treated with MCAT in conjunction with EMD and SCTG. Out of the 54 recessions, 44 were classified as Miller Class I, five as Miller Class II, and five as Miller Class III. Patients were included in the study if they presented at least two adjacent recessions with a depth of ≥ 3 mm. Measurements were made at baseline (immediately before reconstructive surgery) and at 12 months postoperatively. The primary outcome variable was complete root coverage (CRC) (ie, 100% root coverage).
  
  
  RESULTS
  Healing was uneventful in all cases without any complications such as postoperative bleeding, allergic reactions, abscesses, or loss of SCTG. At 12 months, statistically highly significant (P < .0001) root coverage was obtained in all patients and recessions. CRC was obtained in 37 Miller Class I, three Miller Class II, and one Miller Class III recessions, respectively. Mean root coverage was 96%. Mean keratinized tissue width increased statistically highly significantly (P < .004) from 2.04 ± 0.95 mm at baseline to 2.37 ± 0.89 mm at 12 months.
  
  
  CONCLUSIONS
  The present findings indicate that the proposed treatment concept results in predictable coverage of multiple adjacent maxillary Miller Class I, II, and III MAGR.
authors.forename: Anton
authors.initials: A
authors.lastname: Sculean
authors.forename: Raluca
authors.initials: R
authors.lastname: Cosgarea
authors.forename: Alexana
authors.initials: A
authors.lastname: Stähli
authors.forename: Christos
authors.initials: C
authors.lastname: Katsaros
authors.forename: Nicole Birgit
authors.initials: NB
authors.lastname: Arweiler
authors.forename: Richard John
authors.initials: RJ
authors.lastname: Miron
authors.forename: Herbert
authors.initials: H
authors.lastname: Deppe
mesh_terms: D000328:Adult; D003238:Connective Tissue / Q000637:transplantation*; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D005260:Female; D005889:Gingival Recession / Q000145:classification / Q000601:surgery*; D005893:Gingivoplasty / Q000379:methods*; D006801:Humans; D008297:Male; D008437:Maxilla; D008875:Middle Aged; D013524:Surgical Flaps; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D003746:Dental Enamel Proteins