Combined use of coronally positioned flap and tunnel technique

• Published in: International dental journal Vol. 74; p. S292
• Main Authors: Karataş, Özkan, Yüce, Hatice Balcı, Taşkan, Mehmet Murat, Kara, Gözde Işıker, Baysal, Mehmet Raşit
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.10.2024
• ISSN: 0020-6539
• DOI: 10.1016/j.identj.2024.07.265

Gingival recession is a condition that includes many factors in its etiology and is characterized by apical migration of marginal gingiva. Different mucogingival surgical methods or combinations of these methods can be preferred in treatment of gingival recession. A 34-year-old male patient applied to periodontology clinic with sensitivity and aesthetic problems in his maxillary central teeth. In clinical evaluation, it was observed that there was a Miller II class, 3 mm gingival recession in relevant teeth. The patient underwent initial periodontal therapy. After adequate oral hygiene was achieved, it was decided to apply coronally positioned flap. On the day of procedure, vertical incisions were made on distal parts of teeth 11 and 21. Care was taken to preserve blood supply in this area by leaving papilla intact between teeth. A tunnel was created under papilla and high frenum attachments were dissected. Ensuring adequate flap stretching, tissue was moved coronally and procedure was terminated. At end of 4-month follow-up, it was observed that complete root closure was achieved. The McCall festoon-type fibrotic band amount was reduced through vertical incisions, allowing the tissue to surround the tooth. At the same time, it is aimed to increase blood supply of tissue by leaving papilla intact. In addition, by dissecting high frenum attachments, possible stress on tissue transferred coronally after procedure was prevented. In this case, treatment was performed by combining coronally positioned flap and tunnel technique. It has been observed that applying different techniques together will yield successful results with correct case selection.