Managing trauma-induced multiple gingival recessions associated with canine malposition using a modified tunneling technique and subepithelial connective tissue graft: A case report

Bellia Sukma Rengganis, Rezmelia Sari, Raja Azman Raja Awang

Abstract


Introduction: Managing multiple gingival recessions in the aesthetic zone presents a clinical challenge, particularly in cases involving tooth malposition, extrusion, and irregular bone loss resulting from trauma. These factors complicate treatment selection. The Laterally Closed Tunnel (LCT) and Modified Coronally Advanced Tunnel (MCAT), both modified tunneling techniques, offer several advantages when combined with a Subepithelial Connective Tissue Graft (SCTG), including enhanced blood supply, improved graft nutrition, and reduced postoperative morbidity due to minimal vertical incisions and limited flap extension. This case report aims to demonstrate the effectiveness of this combined technique in treating multiple gingival recessions. Case report: A 20-year-old male patient presented with hypersensitivity and aesthetic concerns following accidental trauma. Clinical examination revealed Miller Class III/RT2 Cairo gingival recession on the buccal aspect of left maxillary canine and Miller Class I/RT1 Cairo gingival recession on the left maxillary first premolar, associated with canine malposition and extrusion, a recession depth of up to 7 mm, and inadequate keratinized tissue. The patient was treated using a combination of LCT and MCAT with SCTG. At the 3-month follow-up, substantial root coverage, increased soft tissue thickness, and improved gingival aesthetics were achieved, along with resolution of dentine hypersensitivity. Conclusion: The combination of LCT, MCAT, and SCTG techniques appears to be an effective treatment option for managing complex trauma-induced multiple gingival recessions associated with tooth malposition, providing favourable root coverage and improved soft tissue aesthetics.


Keywords


Trauma-induced, multiple gingival recessions, malpositioned tooth, modified tunneling technique, subepithelial connection tissue graft

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References


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DOI: https://doi.org/10.24198/pjd.vol38no2.66919

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