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Root coverage of type 2/3 gingival recession using recombinant human fibroblast growth factor-2 in combination with

Akiyoshi Funato¹, Akihiko Katayama², Chihiro Ishikura¹

¹Nagisa Dental Clinic, Kanazawa, Japan.

Clinical Advances in Periodontics

|February 2, 2026

Abstract

Background:

One of the most challenging aspects of the treatment of Cairo Recession Type (RT) 2/3 gingival recession is the loss of adjacent interdental tissue. Successful treatment can be achieved by repositioning the interdental tissue and applying a connective tissue graft (CTG).

Methods And Results:

Two patients with RT2/3 gingival recession were treated using the vertical incision tunnel (VIT) technique. Recombinant human fibroblast growth factor-2 (rhFGF-2)-soaked carbonate apatite (CO₃Ap) was placed in the interdental space, while rhFGF-2-soaked CTG was used to cover the exposed root surfaces. Over a follow-up period of up to 2 years, complete or significant root coverage was achieved in both cases. Interdental papillae were successfully reconstructed; however, complete papillary filling was not achieved.

Conclusions:

The combination of rhFGF-2-soaked CO₃Ap in the interdental space and rhFGF-2-soaked CTG for root coverage represents an effective approach for treating RT3 gingival recessions.

Plain Language Summary:

Gum recession is a common dental condition where the gums pull away from the teeth, leaving the roots exposed. This can lead to tooth sensitivity, increased risk of decay, and esthetic concerns. Treating advanced forms-classified as Type 2 and Type 3-is especially difficult because not only are the roots exposed, but the gum tissue between the teeth is also lost. In this case report, two patients with these advanced types of gum recession were treated using a novel approach that combines regenerative materials with a minimally invasive surgical technique. A tissue-regenerating protein called rhFGF-2 was applied to both a synthetic bone substitute (CO₃Ap) placed between the teeth and to soft tissue taken from the roof of the mouth. This tissue was used to cover the exposed roots. Over the course of follow-up, the treated areas healed well: most of the roots became re-covered with healthy gum tissue, and the tissue between the teeth, although not fully restored, showed clear signs of regeneration. While further studies are needed, this technique may provide a promising new option for patients with difficult-to-treat gum recession, especially in cases where traditional treatments have limited success due to loss of supporting structures.

Keywords:

carboapatite connective tissue fibroblast growth factor 2 gingival recession periodontics

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