The Pouch and Tunnel Technique for the Management of Adjacent Gingival Recession Defects: Surgical Correction and One-Year Follow-Up

Abstract

The aim of this report is to present a minimally invasive periodontal plastic surgical method for the treatment of gingival augmentation coronal to area of recession on the facial aspect of the mandibular central incisors. Gingival recession is a relatively common condition patients may discuss with their general dental practitioner. Several improvements in the available corrective surgical techniques have evolved, especially in flap design of periodontal cosmetic surgeries, which can produce a favorable final treatment outcome. A 21-year-old male patient diagnosed with Miller class II marginal tissue recession on the facial surface of the mandibular right and left central incisors was treated with a subepithelial connective tissue autograft underneath a supraperiosteal pouch and tunnel recipient site for multiple areas of gingival recession This flap design allowed intimate contact of donor tissue to the recipient site. One-year follow-up examination of the surgical site revealed excellent and stable root surface coverage. The use of a technique that involves preservation of papilla height and ensures maximum blood supply to the graft helps to attain excellent esthetic and functional long-term results. Given the increasing patient concerns about dental esthetics, the surgical treatment modality presented can be beneficial in efforts to meet the esthetic and functional demands of patients, thereby contributing positively to treatment acceptance and the overall outcome.