Bidirectionally positioned flap surgery: a case report with 3-year follow-up

Area of Science:

• Periodontology
• Regenerative Dentistry

Background:

• Gingival recession affects a significant portion of the population, leading to root exposure and aesthetic concerns.
• Connective tissue grafts and coronally advanced flaps are established periodontal plastic surgery techniques.
• Optimizing these techniques for enhanced outcomes and reduced surgical morbidity is an ongoing area of research.

Observation:

• A 34-year-old female patient presented with a 2-mm Class I gingival recession on the buccal aspect of her maxillary right canine.
• A surgical approach was employed utilizing a full-thickness flap positioned coronally and a partial-thickness flap apically, incorporating connective tissue grafting.

Findings:

• The surgical technique resulted in complete root coverage of the exposed canine root.
• A significant increase in the width of keratinized tissue was observed, from 2 mm to 4 mm at the 6-month follow-up.
• These positive clinical outcomes, including root coverage and increased keratinized tissue, were maintained for a 3-year period.

Implications:

• This single-stage surgical procedure offers a viable method for achieving both complete root coverage and augmenting keratinized tissue width.
• The technique avoids the need for a second surgical site, potentially reducing patient morbidity and treatment complexity.
• This approach may provide a more predictable and efficient solution for managing gingival recession defects.