The Laterally Stretched/Coronally Advanced Flap (LAST/CAF) with Connective Tissue Graf Variation to Treat Deep-Wide...

Area of Science:

• Periodontology
• Oral Surgery
• Regenerative Dentistry

Background:

• Gingival recession treatment faces challenges in graft vascularization, especially for large avascular root surfaces.
• Existing techniques may struggle with extensive root exposure, impacting graft survival and esthetics.

Purpose of the Study:

• To introduce and illustrate a novel surgical technique, the Laterally Stretched/Coronally Advanced Flap (LAST/CAF) combined with connective tissue graft (CTG).
• To demonstrate the efficacy of the LAST/CAF technique in managing severe gingival recessions with extensive exposed root surfaces.

Main Methods:

• A modified flap technique, LAST/CAF, was employed, involving lateral stretching and coronal advancement of the flap.
• The technique was applied to two clinical cases: one with a single deep-wide recession and another with multiple deep-narrow recessions.
• Connective tissue grafts were utilized in conjunction with the flap procedure.

Main Results:

• Successful root coverage was achieved in both clinical cases, even with extensive exposed root surfaces.
• The LAST/CAF technique minimized graft exposure apically and ensured complete coverage without excessive coronal displacement of the mucogingival junction.
• Esthetically pleasing results were obtained in both treated cases.

Conclusions:

• The LAST/CAF technique combined with CTG is a viable and effective approach for treating severe gingival recessions.
• This technique addresses the challenge of graft vascularization and survival in extensive recession defects.
• It offers successful root coverage and favorable esthetic outcomes for diverse recession morphologies.