Comparative Outcomes of Miller Class III Gingival Recession Treatment Using the Tunnel or Coronally Advanced Flap Approach: A Case Report

Introduction: Conflicting results have been published regarding treatment of Miller Class III gingival recession (GR). However, descriptions of esthetic outcomes of different root coverage (RC) approaches are lacking. This report describes the use of two different techniques and graft materials in treatment of recession defects with interdental attachment loss (AL) and provides comparative evaluation of esthetic outcomes using the RC esthetic score (RES) system.Case Presentation: A 50-year-old male presented with esthetic concerns regarding his maxillary teeth as a result of GR. Clinical examination verified the presence of Miller Class I and III GR. Right maxillary defects were managed with a tunneling procedure using acellular dermal matrix graft. Left maxillary teeth had more severe recession and lack of keratinized gingiva. These were managed with a coronally advanced flap (CAF) using a connective tissue graft. One-year postoperative, results showed adequate RC outcomes for both techniques. Evaluation...

[1]  L. Chambrone,et al.  Periodontal soft tissue root coverage procedures: a systematic review from the AAP Regeneration Workshop. , 2015, Journal of periodontology.

[2]  M. Nieri,et al.  Coronally advanced flap with and without connective tissue graft for the treatment of single maxillary gingival recession with loss of inter-dental attachment. A randomized controlled clinical trial. , 2012, Journal of clinical periodontology.

[3]  D. Cipher,et al.  A comparative study of root defect coverage using an acellular dermal matrix with and without a recombinant human platelet-derived growth factor. , 2012, Journal of periodontology.

[4]  G. Pini-Prato The Miller classification of gingival recession: limits and drawbacks. , 2011, Journal of clinical periodontology.

[5]  L. Francetti,et al.  Root coverage esthetic score after treatment of gingival recession: an interrater agreement multicenter study. , 2010, Journal of periodontology.

[6]  J. Shulman,et al.  A comparative study of root coverage using two different acellular dermal matrix products. , 2010, Journal of periodontology.

[7]  E. Allen Subpapillary continuous sling suturing method for soft tissue grafting with the tunneling technique. , 2010, The International journal of periodontics & restorative dentistry.

[8]  C. Mazzotti,et al.  Coronally advanced flap with and without vertical releasing incisions for the treatment of multiple gingival recessions: a comparative controlled randomized clinical trial. , 2009, Journal of periodontology.

[9]  G. Pini Prato,et al.  Root coverage esthetic score: a system to evaluate the esthetic outcome of the treatment of gingival recession through evaluation of clinical cases. , 2009, Journal of periodontology.

[10]  R. Cohen,et al.  The etiology and prevalence of gingival recession. , 2003, Journal of the American Dental Association.

[11]  Miller Pd Root coverage using the free soft tissue autograft following citric acid application. III. A successful and predictable procedure in areas of deep-wide recession. , 1985 .

[12]  P. Miller,et al.  A classification of marginal tissue recession. , 1985, The International journal of periodontics & restorative dentistry.

[13]  Sullivan Hc,et al.  Free autogenous gingival grafts: III. Utilization of grafts in the treatment of gingival recession , 1968 .