THE USE OF THE MODIFIED DE-EPITHELIALIZED FREE GINGIVAL GRAFT WITH MODIFIED CORONALLY ADVANCED TUNNEL IN THE AESTHETIC REHABILITATION OF THE ANTERIOR DENTITION. CASE REPORT

Background: The frequency of gingival recessions is very high. The treatment of RT1 defects often results in
complete root coverage. Often gingival recessions are associated with chronic periodontitis, i.e. RT2 and RT3 defects.
Interproximal bone loss in periodontitis patients leads to papillary volume loss with visualization of black triangles in
the interproximal spaces. The aesthetic demands of dental patients became more sophisticated last decades. Periodontal plastic surgeries became very popular because of overmentioned aesthetic demands and high frequency of recessions both in people with high and low level of individual hygiene. It is stated, that RT1 defects can be treated with complete root coverage. But there is no much data about treatment results of RT2 defects and almost no data about treatment of RT3 defects. Although RT2 defects in some cases can be fully covered, it cannot be guaranteed to the patient in all cases. It is obvious, that dental patients complain not only on root denudation and hypersensitivity, but also interdental black spaces, which appear mostly as a consequence of interproximal bone loss. Although complete root coverage cannot be guaranteed in all patients with RT2 and RT3 defects, patients can demand aesthetic improvement.
Objective: The purpose of this clinical report is to evaluate the effectiveness of the coronally advanced tunnel in
combination with modified deepithelialized free gingival graft (MDFGG) in the treatment of RT2 and RT3 defects.
Results: The scalloped form of the deepithelialized free gingival graft in combination with the coronally advanced
tunnel helped to solve two problems simultaneously: recession closure and papillary reconstruction.
Conclusion: The results lead to further research for the treatment of RT2 and RT3 defects, and also papilla
reconstruction techniques.