Modified Rotated Flap With Double-Component Releasing Incision and One-Sided Tunnel for Mandibular Gingival...

Background: Several techniques have been proposed to deal with gingival recession and gain positive effectiveness and clinically acceptable results. Nevertheless, most require a two-stage surgical procedure with several drawbacks. The present clinical report describes the treatment procedure and clinical outcomes of a modified rotated flap technique incorporating a double-component releasing incision and one-sided tunnel approach for the management of gingival recession. Methods: A 32-year-old male nonsmoker presented with a recession of 6 mm at tooth 33 and 8 mm at tooth 43 after orthodontic treatment. An 8 × 12 × 1.5-mm-size connective tissue graft was harvested from the hard palate. A tunnel flap was created on the mesial side of the canine using split-thickness technique. A reduced incision was placed distal to the second premolar, consisting of a curved segment that followed the cervical contours of the canine and premolars, and concluded with a double-portion releasing incision. The graft was inserted into the tunnel, and the gingival flap was repositioned and secured to cover the exposed tooth surface. Results: After the 6-month and 1-year follow-ups, the mean root coverage rate was 100% without pain and tooth sensitivity. Conclusions: Although additional studies and long-term follow-up will be needed to evaluate the effectiveness of this procedure, this case report showed that this technique not only increases root coverage but also keratinized the mucosa width in only one surgical appointment.