Evaluation of effectiveness of subepithelial connective tissue graft in combination with coronally positioned flap in the treatment of isolated gingival recession in esthetic areas by using surgical microscope

Abstract

Objectives: When maximum precision is required in performing periodontal surgery to satisfy particular esthetic demands, a surgical microscope that enhances complete visualization of the operative field may represent a useful tool. The aim of this case series was to assess clinical outcome of isolated gingival recession treated by using subepithelial connective tissue graft (SCTG) in combination with coronally positioned flap (CPF) in esthetic areas by using surgical microscope. Study Design: A total of 3 cases of isolated gingival recession (Class I and II) located on mandibular incisors were treated by using SCTG in combination with CPF with the aid of a surgical microscope. Gingival recession, probing pocket depth, clinical attachment loss, and width of keratinized gingiva were recorded at baseline, before surgery and at 6 months following surgery. Results: Prior to surgery, there were 2 mm gingival recession (REC), 3 mm clinical attachment loss (CAL) with PPD of 1 mm in two cases while one case had 3 mm gingival recession, 4 mm clinical attachment loss with PPD of 1 mm. 6 months post surgery, 2 cases showed 2 mm reduction of gingival recession indicating 100% root coverage while one case showed 80% of root coverage (2 mm reduction of gingival recession). Conclusion: In the present case report, qualitative aesthetic evaluation of the treated cases showed better searing and marginal profile. This could be due to an atraumatic surgical approach and excellent visualization of the operative field by using surgical microscope. Microsurgery enhances normal vision through magnification and favorable lightening which would lead to an improvement in cosmetic results and patient comfort level.