SURGICAL TREATMENT OF MULTIPLE GINGIVAL RECESSIONS WITH TUNNEL TECHNIQUE USING FREE GINGIVAL GRAFT: CLINICAL CASE SERIES

Background:Mucogingival periodontal surgery is a surgical procedure to correct defects in the morphology,
position, and/or quantity of soft tissue and underlying bone support around teeth. Various methods can be performed
for the surgical management of the recession defects of gingiva. Different surgical techniques have been advocated
for root coverage, like free soft tissue graft procedures, free gingival graft and sub-epithelial connective tissue graft,
pedicle soft tissue graft, rotational flap and flap advancement, pouch and tunnel techniques and guided tissue
regeneration. Free gingival graft is a reliable mucogingival surgical procedure to cover localized gingival recessions.
Objective: The aim of this case series was to evaluate the results obtained by the surgical treatment of multiple
gingival recessions with tunnel technique using free gingival graft.
Materials and Methods: This case series included 18 patients with localized multiple gingival recessions who
underwent surgical treatment using free gingival graft from 2023 to 2025. The Miller and Cairo classifications was
used to classify gingival recession. The following clinical parameters were measured:Probing pocket depth
(PD);Clinical attachment level (CAL);Recession depth (RD) ;Recession width (RW). Professional hygiene was
performed before surgical treatment.
Free gingival graft was used to close the recession in all patients. Evaluations of clinical changes (recession depth,
height of keratinized tissue) and patient satisfaction were performed over a follow-up period of 12 months.
Results: Adequate keratinized gingival width, thickening of the gingival phenotype, and treatment of recession were
observed at follow-up appointments on the 3rd month and 12th month. At baseline, six months, and one year
postoperatively, clinical measurements demonstrated the effectiveness of free gingival graft in improving soft tissue
parameters in cases of gingival recession. All patients complained of hypersensitivity before surgery, and six months
after treatment, a third percentage of patients reported mild hypersensitivity complaints. All patients were satisfied
with the aesthetic results of the procedure.
Conclusion: Free gingival graft can be used as a predictive treatment modality for recession defects and the results
can be well maintained with optimal care and patient satisfaction.