Traditional and modified tunnel technique for the treatment of maxillary anterior teeth gingival recession

Abstract

Objective To compare the clinical effect of the tunnel technique (TUN) and vestibular incision subperiosteal tunnel access (VISTA) combining connective tissue grafts (CTGs) on recovering the exposed root surface in a case of gingival recession over the upper anterior teeth and then to provide clinical evidence for gingival recession treatment. Methods A case of gingival recession (Miller I type) over teeth 13-14 and 22-23 was treated using different techniques bilaterally. 22-23 were treated by a TUN combined CTG transplantation,while teeth 13-14 were treated by a VISTA technique combined with CTG transplantation. The gingival retraction height (GRH), gingival retraction width (GRW), keratinized gingival width (KW), root coverage aesthetic score (RES) and visual analog scale (VAS) were measured after operation. Results The effect of post-operation were ideal and complete ginglval recovering were achieved, the postoperative effects of the two methods were stable, GRH and GRW decreased, and KW increased. RES was 10. The VAS score of VISTA combined with CTG transplantation was 6, which was higher than that of TUN+CTG. Conclusion Gingival recession can be treated by TUN+CTG or VISTA+CTG with ideal prognosis. VISTA with an additional incision facilitates the operative procedure but leads to less comfort.

Keywords

• tunnel technique
• vestibular incision subperiosteal tunnel access
• gingival recession
• root surface coverage
• connective tissue graft
• root coverage esthetic score
• gingival recession height
• gingival recession width
• keratinized tissue