Trivector Traction Suturing Technique in Minimally Invasive Root Coverage Procedures: A Report of Two Cases

Predictable root coverage in gingival recession requires stable flap positioning and controlled coronal advancement. Conventional suturing techniques, while effective, exhibit certain shortcomings. This case report presents the trivector traction suturing technique to enhance flap stabilization and coronal advancement. Two systemically healthy females with multiple RT1, RT2, and RT3 recession defects underwent minimally invasive tunneling with xenogenic volume-stable collagen matrix. A three-point anchorage system combining interdental modified vertical mattress and buccal horizontal mattress sutures embedded in composite stops was used. Sutures were retained for 21 days. In case 1, complete root coverage (CRC) was achieved by 3 months. In case 2, CRC was observed at 6 months. Outcomes remained stable at 12 months, with increased gingival thickness and resolution of hypersensitivity. Within the limitations of this two-case report, the technique demonstrated sustained coronal stability and favorable 12-month outcomes. Controlled trials are required to validate reproducibility and effectiveness.