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

Abstract

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 using RES indicated a higher score for sites treated with the tunnel approach than for CAF sites.Conclusions: GR defects with mild interdental AL can be treated with up to 100% RC using a tunnel or CAF approach. In this case, the tunnel approach led to a superior esthetic outcome.