visual
Clinical cases

Clinical Case Study 2 - Coverage of multiple gingival recessions in the maxilla using the modified coronally advanced tunnel technique and subepithelial connective tissue grafts

29th of August 2022

The following parameters should be considered when planning a surgical approach in the treatment of multiple gingival recessions: the type and size of the recessions, the phenotype, the width of the keratinized tissue, the condition of the gingival papillae, and the teeth position. For recessions of similar dimensions, especially in the case of low and narrow gingival papillae, the modified tunnel technique is the preferred method. In this approach, the flap is prepared in the split-full-split manner (split in the papillary area, full thickness until the mucogingival junction, and split again). In areas where the phenotype is thin, the zone of the keratinized tissue is narrow (or non-existent), and the tooth position is incorrect, a subepithelial connective tissue graft (SCTG) should be applied. In the presented case, the SCTG was positioned in the molar, premolar, and canine areas. A coronally advanced flap should fully cover the SCTGs. Sutures are removed after fourteen days. The modified tunnel technique allows optimum esthetic results to be achieved, and significant improvements are already visible a few weeks after the procedure (the last images were taken after six months).

visual
visual
visual
visual
visual
visual