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KMID : 1044820210510060398
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Journal of Periodontal & Implant Science
2021 Volume.51 No. 6 p.398 ~ p.408
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Modified tunneling technique for root coverage of anterior mandible using minimal soft tissue harvesting and volume-stable collagen matrix: a retrospective study
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Lee Yoon-Sub
Lee Da-Jung
Kim Sung-Tae
Ku Young
Rhyu In-Chul
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Abstract
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Purpose: In this study, we aimed to evaluate the clinical validity of the modified tunneling technique using minimal soft tissue harvesting and volume-stable collagen matrix in the anterior mandible.
Methods: In total, 27 anterior mandibular teeth and palatal donor sites in 17 patients with ≥1 mm of gingival recession (GR) were analyzed before and after root coverage. For the recipient sites, vertical vestibular incisions were made in the interdental area and a subperiosteal tunnel was created with an elevator. After both sides of the marginal gingiva were tied to one another, a prepared connective tissue graft and volume-stable collagen matrix were inserted through the vestibular vertical incision and were fixed with resorbable suture material. The root coverage results of the recipient site were measured at baseline (T0), 3 weeks (T3), 12 weeks (T12), and the latest visit (Tl). For palatal donor sites, a free gingival graft from a pre-decided area avoiding the main trunk of the greater palatine artery was harvested using a prefabricated surgical template at a depth of 2 mm after de-epithelization using a rotating bur. In each patient, the clinical and volumetric changes at the donor sites between T0 and T3 were measured.
Results: During an average follow-up of 14.5 months, teeth with denuded root lengths of 1?3 mm (n=12), 3?6 mm (n=11), and >6 mm (n=2) achieved root coverage of 97.01%±7.65%, 86.70%±5.66%, and 82.53%±1.39%, respectively. Miller classification I (n=12), II (n=10), and III (n=3) teeth showed mean coverage rates of 97.01%±7.65%, 86.91%±5.90%, and 83.19%±1.62%, respectively. At the donor sites, an average defect depth of 1.41 mm (70.5%) recovered in 3 weeks, and the wounds were epithelized completely in all cases.
Conclusions: The modified tunneling technique in this study is a promising treatment modality for overcoming GR in the anterior mandible.
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KEYWORD
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Gingival recession, Connective tissue, Gingivoplasty
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