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      Minimally invasive intrasulcular tunneling technique for treatment of gingival recessions: A case series

      case-report

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          Abstract

          Coronally advanced flap (CAF) by tunneling procedure was applied on four cases of gingival recession. Post‐operative follow‐up, at different time breaks, recorded full coverage of almost all receded root surfaces. The technique and the clinical outcome of this technique will be demonstrated in this case series report.

          Abstract

          Coronally advanced flap (CAF) by tunneling procedure is considered one of the effective root coverage procedures, particularly when it is combined with CTG, in modification of the conventional technique. Post‐operative follow up, at different time breaks, recorded full coverage of almost all receded root surfaces.

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          Most cited references13

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          The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: an explorative and reliability study.

          The aims of this study were (i) to test the reliability of a new classification system of gingival recessions using the level of interproximal clinical attachment as an identification criterion and (ii) to explore the predictive value of the resulting classification system on the final root coverage outcomes. Patients showing at least one buccal gingival recession were recruited by one operator. Three recession types (RT) were identified. While class RT1 included gingival recession with no loss of interproximal attachment, class RT2 recession was associated with interproximal attachment loss less than or equal to the buccal site and class RT3 showed higher interproximal attachment loss than the buccal site. The classification was tested by two examiners blinded to the data collected by the other examiner. Intra-rater and inter-rater agreement was assessed. Furthermore, the 6-month root coverage outcomes of consecutively treated gingival recessions were retrospectively evaluated in order to explore the predictive value of the proposed classification on the final recession reduction (Rec Red). The new classification system of gingival recessions was tested in a total of 116 gingival recessions (mean 3.2±1.2 mm) in 25 patients. The intra-class correlation coefficient (ICC) for inter-rater agreement was 0.86, showing an almost perfect agreement between the examiners. The RT classification was predictive of the final Rec Red (p<0.0001) at the 6-month follow-up in 109 treated gingival recessions. The evaluation of interproximal clinical attachment level may be used to classify gingival recession defects and to predict the final root coverage outcomes. © 2011 John Wiley & Sons A/S.
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            Patient outcomes following subepithelial connective tissue graft and free gingival graft procedures.

            Subepithelial connective tissue grafts (CTGs) and free gingival grafts (FGGs) are common periodontal procedures with similar indications; however, they may differ regarding patient outcomes. Reports on postoperative periodontal patient outcomes are limited. The aim of this observational trial was to compare patient-based outcomes for CTGs and FGGs. Patients who received CTG or FGG completed postoperative questionnaires at 3 days and 3 weeks to assess pain, number of analgesic pills taken, and number of days pills were taken. Postoperative pain was assessed using a visual analog scale (VAS). Twenty-three subjects (12 CTGs and 11 FGGs) completed the study. Differences between CTG and FGG groups in VAS pain scores at 3 days did not reach statistical significance. The proportion of subjects reporting pain in the palate at 3 days was significantly greater for FGG (P <0.05). There were no significant intergroup differences at 3 weeks. For the FGG group, 3-week VAS pain scores were less than the 3-day ones (P <0.01). For the entire study population, the number of days analgesic pills were taken, total number of analgesic pills taken, and number of pills taken from day 3 to the end of the study correlated with the 3-week pain scores. FGG is associated with a greater incidence of donor site pain compared to CTG at the early postoperative period. Longer-term pain after soft tissue grafting is associated with greater analgesic usage. There is an opportunity to improve the postoperative protocols of soft tissue grafting, particularly for FGG.
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              Treatment of multiple adjacent gingival recessions with the tunnel subepithelial connective tissue graft: a clinical report.

              This article describes a surgical periodontal plastic procedure for the coverage of multiple adjacent gingival recessions. This surgical technique is based on the construction of a tunnel under the gingival tissue by means of a sulcular incision beyond the mucogingival line without raising the papillae. A large connective tissue graft obtained from the palatal mucosa is introduced through this tunnel, covering the adjacent gingival recessions. A suturing technique to allow this graft to slip through the tunnel under the gingival tissues and to secure and stabilize the graft covering the recessions is described. Twelve-month postoperative results are presented from 21 teeth that were treated with this technique: 100% root coverage was achieved in 66.7% of the recessions treated, with a mean root surface coverage of 91.6%. This study suggests that the use of this surgical procedure allows the treatment of multiple adjacent recessions in a single procedure with adequate early healing and highly predictable root coverage results.
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                Author and article information

                Contributors
                Faraedon.mostafa@univsul.edu.iq
                Journal
                Clin Case Rep
                Clin Case Rep
                10.1002/(ISSN)2050-0904
                CCR3
                Clinical Case Reports
                John Wiley and Sons Inc. (Hoboken )
                2050-0904
                05 April 2022
                April 2022
                : 10
                : 4 ( doiID: 10.1002/ccr3.v10.4 )
                : e05699
                Affiliations
                [ 1 ] ringgold 275719; Department of Periodontics College of Dentistry University of Sulaimani Sulaymaniyah Iraq
                Author notes
                [*] [* ] Correspondence

                Faraedon M. Zardawi, College of Dentistry, University of Sulaimani, Old Campus, Madam Mitterrand Street, 1124‐30 Sulaimani, Iraq.

                Email: Faraedon.mostafa@ 123456univsul.edu.iq

                Author information
                https://orcid.org/0000-0003-3650-3817
                Article
                CCR35699
                10.1002/ccr3.5699
                8980938
                8b6f64ce-93d0-4c8d-a4bc-4c1be8704953
                © 2022 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 March 2022
                : 30 July 2021
                : 23 March 2022
                Page count
                Figures: 7, Tables: 2, Pages: 6, Words: 2390
                Product
                Categories
                Case Report
                Case Reports
                Custom metadata
                2.0
                April 2022
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.3 mode:remove_FC converted:05.04.2022

                advanced flap,connective tissue graft,modification of tunneling,tunneling procedure

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