Treatment of multiple gingival recession with modified tunnel technique: A case report.

Yıldırım S., Guliyev R., Lütfioğlu M.

Europerio10, Kobenhavn, Danimarka, 15 - 18 Haziran 2022, cilt.49, ss.322-323, (Özet Bildiri)

  • Yayın Türü: Bildiri / Özet Bildiri
  • Cilt numarası: 49
  • Doi Numarası: 10.1111/jcpe.13636
  • Basıldığı Şehir: Kobenhavn
  • Basıldığı Ülke: Danimarka
  • Sayfa Sayıları: ss.322-323
  • Ondokuz Mayıs Üniversitesi Adresli: Evet

Özet

 ff f f fgrfcBackground: Gingival recession is the apical displacement of the gingi- val margin leading to exposed root surfaces, resulting an unaesthetic appearance and sensitivity. This case report, presented the treatment of bilateral multiple gingival recession with the tunnel technique. Description of the procedure: The female 35-year-old systemically healthy non-smoker patient was applied to periodontology clinic with complaints of esthetic impairment and, hypersensitivity and pain in the lower anterior/premolar region. The patient had Cairo class-I bilateral multiple gingival recession, insufficient keratinized gingiva, and mobile gingival margin due to muscle attachments in premolar region. Periodontal examinations including probing pocket depth, clinical attachment level, gingival recession depth, keratinized gingival width were evaluated at baseline and during follow up. After initial phase-I treatment, tunnel operation was per- formed first on 41-42-43-44-45 and, 10weeks later on 31-32-33-34-35 teeth regions. The pre-op/post-op intraoral pho- tographs were taken. Following local anesthesia, deepithelialized connective tissue grafts(CTG) were harvested from right and left palatal regions. The full-thickness designed tunnel flap is raised and prepared beyond the level of mucogingival junction leaving the interdental papilla intact. The mucoperiosteal-flap is carefully extended mesially and distally until the adjacent recessions are con- nected. CTG was fixed to the flap with resorbable-monofilament sutures. The flap and CTG were coronally positioned together to cemeneto-enamel-junction, and sutured using interrupted sling sutures with nonresorbable-monofilament polypropylene. Postop- erative chlorhexidine and antibiotics were prescribed. Sutures were removed 2 weeks later. Outcomes: Even the recessions of teeth 34 and 35 were not completely covered, the exposed root surfaces were restorated rather favourably despite the rotated teeth in the anterior region. Besides, the keratinized and attached gingiva width was increased. Conclusions: Accordingly, it can be concluded that the treatment of multiple recessions with tunnel technique is convenient to achieve root closure and increased attached gingiva width at the same time.val margin leading to exposed root surfaces, resulting an unaesthetic appearance and sensitivity. This case report, presented the treatment of bilateral multiple gingival recession with the tunnel technique. Description of the procedure: The female 35-year-old systemically healthy non-smoker patient was applied to periodontology clinic with complaints of esthetic impairment and, hypersensitivity and pain in the lower anterior/premolar region. The patient had Cairo class-I bilateral multiple gingival recession, insufficient keratinized gingiva, and mobile gingival margin due to muscle attachments in premolar region. Periodontal examinations including probing pocket depth, clinical attachment level, gingival recession depth, keratinized gingival width were evaluated at baseline and during follow up. After initial phase-I treatment, tunnel operation was per- formed first on 41-42-43-44-45 and, 10 weeks later on 31-32-33-34-35 teeth regions. The pre-op/post-op intraoral pho- tographs were taken. Following local anesthesia, deepithelialized connective tissue grafts(CTG) were harvested from right and left palatal regions. The full-thickness designed tunnel flap is raised and prepared beyond the level of mucogingival junction leaving the interdental papilla intact. The mucoperiosteal-flap is carefully extended mesially and distally until the adjacent recessions are con- nected. CTG was fixed to the flap with resorbable-monofilament 322 ABSTRACT 
Treatment of multiple gingival recession with
modified tunnel technique: A case report
S. Yildirim1 , R. Guliyev1 , M. Lutfioglu1
1
Department of Periodontology, Ondokuz Mayis University, Samsun,
Turkey
Background: Gingival recession is the apical displacement of the gingi-
val margin leading to exposed root surfaces, resulting an unaesthetic
appearance and sensitivity. This case report, presented the treatment
of bilateral multiple gingival recession with the tunnel technique.
Description of the procedure: The female 35-year-old systemically
healthy non-smoker patient was applied to periodontology clinic
with complaints of esthetic impairment and, hypersensitivity and
pain in the lower anterior/premolar region. The patient had Cairo
class-I bilateral multiple gingival recession, insufficient keratinized
gingiva, and mobile gingival margin due to muscle attachments in
premolar region. Periodontal examinations including probing
pocket depth, clinical attachment level, gingival recession depth,
keratinized gingival width were evaluated at baseline and during
follow up. After initial phase-I treatment, tunnel operation was per-
formed first on 41-42-43-44-45 and, 10 weeks later on
31-32-33-34-35 teeth regions. The pre-op/post-op intraoral pho-
tographs were taken. Following local anesthesia, deepithelialized
connective tissue grafts(CTG) were harvested from right and left
palatal regions. The full-thickness designed tunnel flap is raised and
prepared beyond the level of mucogingival junction leaving the
interdental papilla intact. The mucoperiosteal-flap is carefully
extended mesially and distally until the adjacent recessions are con-
nected. CTG was fixed to the flap with resorbable-monofilament
322 ABSTRACT
: Gingival recession is the apical displacement of the gingi- val margin leading to exposed root surfaces, resulting an unaesthetic appearance and sensitivity. This case report, presented the treatment of bilateral multiple gingival recession with the tunnel technique. Description of the procedure: The female 35-year-old systemically healthy non-smoker patient was applied to periodontology clinic with complaints of esthetic impairment and, hypersensitivity and pain in the lower anterior/premolar region. The patient had Cairo class-I bilateral multiple gingival recession, insufficient keratinized gingiva, and mobile gingival margin due to muscle attachments in premolar region. Periodontal examinations including probing pocket depth, clinical attachment level, gingival recession depth, keratinized gingival width were evaluated at baseline and during follow up. After initial phase-I treatment, tunnel operation was per- formed first on 41-42-43-44-45 and, 10weeks later on 31-32-33-34-35 teeth regions. The pre-op/post-op intraoral pho- tographs were taken. Following local anesthesia, deepithelialized connective tissue grafts(CTG) were harvested from right and left palatal regions. The full-thickness designed tunnel flap is raised and prepared beyond the level of mucogingival junction leaving the interdental papilla intact. The mucoperiosteal-flap is carefully extended mesially and distally until the adjacent recessions are con- nected. CTG was fixed to the flap with resorbable-monofilament sutures. The flap and CTG were coronally positioned together to cemeneto-enamel-junction, and sutured using interrupted sling sutures with nonresorbable-monofilament polypropylene. Postop- erative chlorhexidine and antibiotics were prescribed. Sutures were removed 2 weeks later. Outcomes: Even the recessions of teeth 34 and 35 were not completely covered, the exposed root surfaces were restorated rather favourably despite the rotated teeth in the anterior region. Besides, the keratinized and attached gingiva width was increased. Conclusions: Accordingly, it can be concluded that the treatment of multiple recessions with tunnel technique is convenient to achieve root closure and increased attached gingiva width at the same time.: Gingival recession is the apical displacement of the gingi-
val margin leading to exposed root surfaces, resulting an unaesthetic
appearance and sensitivity. This case report, presented the treatment
of bilateral multiple gingival recession with the tunnel technique.
Description of the procedure: The female 35-year-old systemically
healthy non-smoker patient was applied to periodontology clinic
with complaints of esthetic impairment and, hypersensitivity and
pain in the lower anterior/premolar region. The patient had Cairo
class-I bilateral multiple gingival recession, insufficient keratinized
gingiva, and mobile gingival margin due to muscle attachments in
premolar region. Periodontal examinations including probing
pocket depth, clinical attachment level, gingival recession depth,
keratinized gingival width were evaluated at baseline and during
follow up. After initial phase-I treatment, tunnel operation was per-
formed first on 41-42-43-44-45 and, 10 weeks later on
31-32-33-34-35 teeth regions. The pre-op/post-op intraoral pho-
tographs were taken. Following local anesthesia, deepithelialized
connective tissue grafts(CTG) were harvested from right and left
palatal regions. The full-thickness designed tunnel flap is raised and
prepared beyond the level of mucogingival junction leaving the
interdental papilla intact. The mucoperiosteal-flap is carefully
extended mesially and distally until the adjacent recessions are con-
nected. CTG was fixed to the flap with resorbable-monofilament
322 ABSTRACT
: Gingival recession is the apical displacement of the gingi-
val margin leading to exposed root surfaces, resulting an unaesthetic
appearance and sensitivity. This case report, presented the treatment
of bilateral multiple gingival recession with the tunnel technique.
Description of the procedure: The female 35-year-old systemically
healthy non-smoker patient was applied to periodontology clinic
with complaints of esthetic impairment and, hypersensitivity and
pain in the lower anterior/premolar region. The patient had Cairo
class-I bilateral multiple gingival recession, insufficient keratinized
gingiva, and mobile gingival margin due to muscle attachments in
premolar region. Periodontal examinations including probing
pocket depth, clinical attachment level, gingival recession depth,
keratinized gingival width were evaluated at baseline and during
follow up. After initial phase-I treatment, tunnel operation was per-
formed first on 41-42-43-44-45 and, 10 weeks later on
31-32-33-34-35 teeth regions. The pre-op/post-op intraoral pho-
tographs were taken. Following local anesthesia, deepithelialized
connective tissue grafts(CTG) were harvested from right and left
palatal regions. The full-thickness designed tunnel flap is raised and
prepared beyond the level of mucogingival junction leaving the
interdental papilla intact. The mucoperiosteal-flap is carefully
extended mesially and distally until the adjacent recessions are con-
nected. CTG was fixed to the flap with resorbable-monofilament
322 ABSTRACT
: Gingival recession is the apical displacement of the gingi-
val margin leading to exposed root surfaces, resulting an unaesthetic
appearance and sensitivity. This case report, presented the treatment
of bilateral multiple gingival recession with the tunnel technique.
Description of the procedure: The female 35-year-old systemically
healthy non-smoker patient was applied to periodontology clinic
with complaints of esthetic impairment and, hypersensitivity and
pain in the lower anterior/premolar region. The patient had Cairo
class-I bilateral multiple gingival recession, insufficient keratinized
gingiva, and mobile gingival margin due to muscle attachments in
premolar region. Periodontal examinations including probing
pocket depth, clinical attachment level, gingival recession depth,
keratinized gingival width were evaluated at baseline and during
follow up. After initial phase-I treatment, tunnel operation was per-
formed first on 41-42-43-44-45 and, 10 weeks later on
31-32-33-34-35 teeth regions. The pre-op/post-op intraoral pho-
tographs were taken. Following local anesthesia, deepithelialized
connective tissue grafts(CTG) were harvested from right and left
palatal regions. The full-thickness designed tunnel flap is raised and
prepared beyond the level of mucogingival junction leaving the
interdental papilla intact. The mucoperiosteal-flap is carefully
extended mesially and distally until the adjacent recessions are con-
nected. CTG was fixed to the flap with resorbable-monofilament
322 ABSTRACT

 ff f f fgrfcBackground: Gingival recession is the apical displacement of the gingi- val margin leading to exposed root surfaces, resulting an unaesthetic appearance and sensitivity. This case report, presented the treatment of bilateral multiple gingival recession with the tunnel technique. Description of the procedure: The female 35-year-old systemically healthy non-smoker patient was applied to periodontology clinic with complaints of esthetic impairment and, hypersensitivity and pain in the lower anterior/premolar region. The patient had Cairo class-I bilateral multiple gingival recession, insufficient keratinized gingiva, and mobile gingival margin due to muscle attachments in premolar region. Periodontal examinations including probing pocket depth, clinical attachment level, gingival recession depth, keratinized gingival width were evaluated at baseline and during follow up. After initial phase-I treatment, tunnel operation was per- formed first on 41-42-43-44-45 and, 10weeks later on 31-32-33-34-35 teeth regions. The pre-op/post-op intraoral pho- tographs were taken. Following local anesthesia, deepithelialized connective tissue grafts(CTG) were harvested from right and left palatal regions. The full-thickness designed tunnel flap is raised and prepared beyond the level of mucogingival junction leaving the interdental papilla intact. The mucoperiosteal-flap is carefully extended mesially and distally until the adjacent recessions are con- nected. CTG was fixed to the flap with resorbable-monofilament sutures. The flap and CTG were coronally positioned together to cemeneto-enamel-junction, and sutured using interrupted sling sutures with nonresorbable-monofilament polypropylene. Postop- erative chlorhexidine and antibiotics were prescribed. Sutures were removed 2 weeks later. Outcomes: Even the recessions of teeth 34 and 35 were not completely covered, the exposed root surfaces were restorated rather favourably despite the rotated teeth in the anterior region. Besides, the keratinized and attached gingiva width was increased. Conclusions: Accordingly, it can be concluded that the treatment of multiple recessions with tunnel technique is convenient to achieve root closure and increased attached gingiva width at the same time.val margin leading to exposed root surfaces, resulting an unaesthetic appearance and sensitivity. This case report, presented the treatment of bilateral multiple gingival recession with the tunnel technique. Description of the procedure: The female 35-year-old systemically healthy non-smoker patient was applied to periodontology clinic with complaints of esthetic impairment and, hypersensitivity and pain in the lower anterior/premolar region. The patient had Cairo class-I bilateral multiple gingival recession, insufficient keratinized gingiva, and mobile gingival margin due to muscle attachments in premolar region. Periodontal examinations including probing pocket depth, clinical attachment level, gingival recession depth, keratinized gingival width were evaluated at baseline and during follow up. After initial phase-I treatment, tunnel operation was per- formed first on 41-42-43-44-45 and, 10 weeks later on 31-32-33-34-35 teeth regions. The pre-op/post-op intraoral pho- tographs were taken. Following local anesthesia, deepithelialized connective tissue grafts(CTG) were harvested from right and left palatal regions. The full-thickness designed tunnel flap is raised and prepared beyond the level of mucogingival junction leaving the interdental papilla intact. The mucoperiosteal-flap is carefully extended mesially and distally until the adjacent recessions are con- nected. CTG was fixed to the flap with resorbable-monofilament 322 ABSTRACT
Background: Gingival recession is the apical displacement of the gingi- val margin leading to exposed root surfaces, resulting an unaesthetic appearance and sensitivity. This case report, presented the treatment of bilateral multiple gingival recession with the tunnel technique. Description of the procedure: The female 35-year-old systemically healthy non-smoker patient was applied to periodontology clinic with complaints of esthetic impairment and, hypersensitivity and pain in the lower anterior/premolar region. The patient had Cairo class-I bilateral multiple gingival recession, insufficient keratinized gingiva, and mobile gingival margin due to muscle attachments in premolar region. Periodontal examinations including probing pocket depth, clinical attachment level, gingival recession depth, keratinized gingival width were evaluated at baseline and during follow up. After initial phase-I treatment, tunnel operation was per- formed first on 41-42-43-44-45 and, 10weeks later on 31-32-33-34-35 teeth regions. The pre-op/post-op intraoral pho- tographs were taken. Following local anesthesia, deepithelialized connective tissue grafts(CTG) were harvested from right and left palatal regions. The full-thickness designed tunnel flap is raised and prepared beyond the level of mucogingival junction leaving the interdental papilla intact. The mucoperiosteal-flap is carefully extended mesially and distally until the adjacent recessions are con- nected. CTG was fixed to the flap with resorbable-monofilament sutures. The flap and CTG were coronally positioned together to cemeneto-enamel-junction, and sutured using interrupted sling sutures with nonresorbable-monofilament polypropylene. Postop- erative chlorhexidine and antibiotics were prescribed. Sutures were removed 2 weeks later. Outcomes: Even the recessions of teeth 34 and 35 were not completely covered, the exposed root surfaces were restorated rather favourably despite the rotated teeth in the anterior region. Besides, the keratinized and attached gingiva width was increased. Conclusions: Accordingly, it can be concluded that the treatment of multiple recessions with tunnel technique is convenient to achieve root closure and increased attached gingiva width at the same time.: Gingival recession is the apical displacement of the gingi-
val margin leading to exposed root surfaces, resulting an unaesthetic
appearance and sensitivity. This case report, presented the treatment
of bilateral multiple gingival recession with the tunnel technique.
Description of the procedure: The female 35-year-old systemically
healthy non-smoker patient was applied to periodontology clinic
with complaints of esthetic impairment and, hypersensitivity and
pain in the lower anterior/premolar region. The patient had Cairo
class-I bilateral multiple gingival recession, insufficient keratinized
gingiva, and mobile gingival margin due to muscle attachments in
premolar region. Periodontal examinations including probing
pocket depth, clinical attachment level, gingival recession depth,
keratinized gingival width were evaluated at baseline and during
follow up. After initial phase-I treatment, tunnel operation was per-
formed first on 41-42-43-44-45 and, 10 weeks later on
31-32-33-34-35 teeth regions. The pre-op/post-op intraoral pho-
tographs were taken. Following local anesthesia, deepithelialized
connective tissue grafts(CTG) were harvested from right and left
palatal regions. The full-thickness designed tunnel flap is raised and
prepared beyond the level of mucogingival junction leaving the
interdental papilla intact. The mucoperiosteal-flap is carefully
extended mesially and distally until the adjacent recessions are con-
nected. CTG was fixed to the flap with resorbable-monofilament
322 ABSTRACT
: Gingival recession is the apical displacement of the gingi-
val margin leading to exposed root surfaces, resulting an unaesthetic
appearance and sensitivity. This case report, presented the treatment
of bilateral multiple gingival recession with the tunnel technique.
Description of the procedure: The female 35-year-old systemically
healthy non-smoker patient was applied to periodontology clinic
with complaints of esthetic impairment and, hypersensitivity and
pain in the lower anterior/premolar region. The patient had Cairo
class-I bilateral multiple gingival recession, insufficient keratinized
gingiva, and mobile gingival margin due to muscle attachments in
premolar region. Periodontal examinations including probing
pocket depth, clinical attachment level, gingival recession depth,
keratinized gingival width were evaluated at baseline and during
follow up. After initial phase-I treatment, tunnel operation was per-
formed first on 41-42-43-44-45 and, 10 weeks later on
31-32-33-34-35 teeth regions. The pre-op/post-op intraoral pho-
tographs were taken. Following local anesthesia, deepithelialized
connective tissue grafts(CTG) were harvested from right and left
palatal regions. The full-thickness designed tunnel flap is raised and
prepared beyond the level of mucogingival junction leaving the
interdental papilla intact. The mucoperiosteal-flap is carefully
extended mesially and distally until the adjacent recessions are con-
nected. CTG was fixed to the flap with resorbable-monofilament
322 ABSTRACT
: Gingival recession is the apical displacement of the gingi-
val margin leading to exposed root surfaces, resulting an unaesthetic
appearance and sensitivity. This case report, presented the treatment
of bilateral multiple gingival recession with the tunnel technique.
Description of the procedure: The female 35-year-old systemically
healthy non-smoker patient was applied to periodontology clinic
with complaints of esthetic impairment and, hypersensitivity and
pain in the lower anterior/premolar region. The patient had Cairo
class-I bilateral multiple gingival recession, insufficient keratinized
gingiva, and mobile gingival margin due to muscle attachments in
premolar region. Periodontal examinations including probing
pocket depth, clinical attachment level, gingival recession depth,
keratinized gingival width were evaluated at baseline and during
follow up. After initial phase-I treatment, tunnel operation was per-
formed first on 41-42-43-44-45 and, 10 weeks later on
31-32-33-34-35 teeth regions. The pre-op/post-op intraoral pho-
tographs were taken. Following local anesthesia, deepithelialized
connective tissue grafts(CTG) were harvested from right and left
palatal regions. The full-thickness designed tunnel flap is raised and
prepared beyond the level of mucogingival junction leaving the
interdental papilla intact. The mucoperiosteal-flap is carefully
extended mesially and distally until the adjacent recessions are con-
nected. CTG was fixed to the flap with resorbable-monofilament
322 ABSTRACT