Modified Dufourmentel Flap With Connective Tissue Grafting for Predictable Gingival Cleft Management: A Case Report

Presence of a gingival cleft and marginal tissue recession promotes microbial invasion into tissues by plaque accumulation, leading to inflammation; thus, reducing the stability of marginal tissues. Hence, it is crucial to effectively control these gingival defects before they progress into more intricate mucogingival problems. This is a case report of a 39-year-old male patient who presented with the primary complaint of sensitivity in his upper right posterior teeth while brushing for the past 3 months. A two-stage approach using 'modified Dufourmentel flap' with a microsurgical approach and connective tissue grafting was employed to address the white gingival cleft and associated gingival recession. The objective of the procedure was to eliminate the cleft completely and simultaneously achieve root coverage. Two years follow-up revealed 100% recession coverage and cleft elimination as well as an increase in the width of attached gingiva from 1 to 3 mm and an increase in the width of the keratinized tissue from 2 to 4 mm, while the marginal gingiva remained stable. Employing a microsurgical modified Dufourmentel flap technique substantially enhanced the reliability of outcomes without causing any morbidity to the patient. Modified Dufourmentel flap with connective tissue grafting being a microsurgical procedure achieved complete cleft elimination, complete recession coverage, and enhanced keratinized tissue and attached gingiva two years postoperatively. These findings demonstrate the long-term stability of this newly proposed technique.