Laterally Positioned Multiple Papilla Flap with Connective Tissue Graft for the Treatment of Multiple Adjacent...

This case series evaluated the laterally positioned multiple papilla flap (LPMPF) combined with a connective tissue graft (CTG) for the treatment of multiple adjacent gingival recessions (MAGRs) with a 10-year follow-up. Seventeen systemically healthy, non-smoking adults with RT1 MAGRs were treated. Recession depth (REC), Keratinized tissue width (KTW), percentage of root coverage (RC), achievement of complete root coverage (CRC) and Root Coverage Esthetic Score (RES) were assessed 1, 5, and 10 years after the surgery. At 1 year, mean RC was 92.8% with 80% CRC; outcomes remained stable over time, with 91.5% RC (p = 0.457) and 66% CRC at 10 years (p = 0.172). REC significantly decreased from 2.37 ± 1.16 mm at baseline to 0.19 ± 0.44 mm at 1 year (p < 0.001), with no significant change at 5 or 10 years (p = 1.000). KTW significantly increased from 1.46 ± 0.69 mm at baseline to 2.75 ± 1.08 mm at 1 year (p < 0.001) and remained stable thereafter (p = 1.000). Esthetic outcomes were consistently high (RES ≥ 8.8) and stable across timepoints (p = 0.839). Baseline REC and KTW were not associated with RC or CRC (p > 0.1); greater baseline REC correlated with lower RES at 1 year only (ρ = -0.410; p = 0.003). Within the limitations of the present study, LPMPF + CTG appears to be a reliable treatment for MAGRs, providing favorable long-term outcomes in terms of esthetics and root coverage over a decade.