Minimally Invasive Treatment of Mandibular Anterior Lingual Defects by Vestibular Incision Subperiosteal Tunnel Access Technique and Connective Tissue Graft: A Case Report

Abstract

Introduction: Treatment of recession defects on the lingual surface of mandibular anterior teeth is challenging owing to site‐specific anatomic features of this region. Surgical approaches based on use of subepithelial connective tissue grafts (SCTGs) are considered the “gold standard” for treatment of multiple recession defects. To the best of the authors’ knowledge, this is believed to be the first case report of an attempt to correct lingual recession by SCTG with the minimally invasive vestibular incision subperiosteal tunnel access technique.Case Presentation: A non‐smoking 55‐year‐old male patient presented with hypersensitivity in his mandibular anterior teeth in August 2016. Multiple lingual recession defects were treated by placing a SCTG harvested from the palate underneath the subperiosteal tunnel using a midline access incision. Six months after treatment, a significant increase of root coverage (88.17%), gain in gingival thickness (1.29 mm), and width of keratinized gingiva (1.41 mm) led to a promising outcome and high patient satisfaction.Conclusion: A minimally invasive surgical technique has been presented that can restore the functional properties of lingual gingiva of the mandibular anterior teeth by repairing gingival defects and reestablishing integrity of the zone of keratinized gingiva.