Abstract
The Correction of gingival recessions is an important issue in the field of periodontal plastic surgery. Esthetic concerns are the main indications for root coverage. The selection of the most appropriate soft tissue grafting procedure must be done carefully. The use of a tunnel or a pouch-like design eliminates the need for horizontal or vertical incisions, thereby maximizing the papillary and lateral blood supply to the graft. The use of the subepithelial connective tissue graft offers a combination of both the pedicle flap and the free gingival graft. The pedicle flap allows for possible root coverage since it retains its apical blood supply and therefore survives over an avascular root surface. The free gingival graft supplies a resilient type of connective tissue with a genetic predisposition that ensures thickness and keratinization. This creates suitable housing for the gingival margin of a tooth or crown.
A 34-year-old male patient reported to the department of periodontology with a chief complaint of hypersensitivity and bleeding while brushing in relation to the lower front teeth region. Clinical and radiological examination revealed miller’s class II gingival recession and a clinical attachment loss of 5mm to 6mm in relation to the lower anterior (42-32). Root coverage was attempted in relation to the lower anterior region (42-32) using connective tissue graft harvested from the palatal area. The patient was reviewed subsequently after the procedure and clinical parameters were noted. An increase in clinical attachment level (CAL) and a reduction of 1mm to 3mm of gingival recession was observed. Thus the pouch & tunnel technique with CTG harvesting shows significant results than the other conventional techniques in both patient's compliance and clinical parameters.