Coronally Advanced Flap versus Tunnel on the treatment of gingival recession and peri‑implant mucosal defects: A review of current clinical indications

Abstract

This review assesses evolving landscape of mucogingival surgery for treatment of gingival recession and peri-implant mucosal defects, highlighting an increased awareness of the role of soft tissue and advancements in treatment modalities. In response to diverse mucogingival defects, various treatment approaches have been proposed, with ongoing updates in considerations, prognostic factors, as well as the introduction of novel techniques. A comprehensive and up-to-date exploration of the existing literature is therefore required to consolidate the current understanding of mucogingival surgery.Among all treatment modalities, coronally advanced flap (CAF) and tunneling (TUN) techniques were evaluated for treating gingival recessions and peri-implant mucosal defects, acknowledging challenges due to limited direct comparisons and heterogeneous study groups. While some evidence favored CAF for achieving higher complete root coverage, recent meta-analyses suggest comparable outcomes for both techniques, underscoring the need for better-designed studies.In conclusion, both CAF and TUN exhibit versatility in mucogingival surgery, with considerations for specific clinical scenarios. Future studies should explore surgical duration, post-operative experiences, and comprehensive outcomes such as patient satisfaction, long-term stability, and esthetic results for a more thorough evaluation of these techniques.

Keywords

• Gingival recession
• Root coverage
• Coronally advanced flap
• Tunnel technique
• Connective tissue graft
• Mucogingival surgery