The Pouch and Tunnel Technique for the Management of Adjacent Gingival Recession Defects: Surgical Correction and One-Year Follow-Up
Vikas Deo, Ashok Bhati, Tony Kurien
Citation Information :
Deo V, Bhati A, Kurien T. The Pouch and Tunnel Technique for the Management of Adjacent Gingival Recession Defects: Surgical Correction and One-Year Follow-Up. J Contemp Dent Pract 2010; 11 (5):41-48.
The aim of this report is to present a minimally invasive periodontal plastic surgical method for the treatment of gingival augmentation coronal to area of recession on the facial aspect of the mandibular central incisors.
Background
Gingival recession is a relatively common condition patients may discuss with their general dental practitioner. Several improvements in the available corrective surgical techniques have evolved, especially in flap design of periodontal cosmetic surgeries, which can produce a favorable final treatment outcome.
Case Description
A 21-year-old male patient diagnosed with Miller class II marginal tissue recession on the facial surface of the mandibular right and left central incisors was treated with a subepithelial connective tissue autograft underneath a supraperiosteal pouch and tunnel recipient site for multiple areas of gingival recession This flap design allowed intimate contact of donor tissue to the recipient site. One-year follow-up examination of the surgical site revealed excellent and stable root surface coverage.
Summary
The use of a technique that involves preservation of papilla height and ensures maximum blood supply to the graft helps to attain excellent esthetic and functional long-term results.
Clinical Significance
Given the increasing patient concerns about dental esthetics, the surgical treatment modality presented can be beneficial in efforts to meet the esthetic and functional demands of patients, thereby contributing positively to treatment acceptance and the overall outcome.
Citation
Kurien T, Deo V, Bhati A. The pouch and tunnel technique for the management of adjacent gingival recession defects: Surgical correction and one-year follow-up. J Contemp Dent Pract [Internet]. 2010 October; 11(5):041- 048. Available from: http://www.thejcdp.com/ journal/view/volume11-issue5-deo
Glossary of periodontal terms. 4th ed. Chicago: The Academy; 2001. p. 44.
Prevalence and etiology of gingival recession. J Periodontol. 1967; 38(4):316-22.
Self-inflicted gingival injuries: literature review and case report. J Periodontol. 1983; 54(5):299-304.
Gingival recession. J Dent. 1984; 12(1):29-35.
Mucogingival therapy. Ann Periodontol. 1996; 1(1):671-701.
Oral hygiene, gingivitis and periodontal breakdown in adult Tanzanians. J Periodontal Res. 1986; 21(3):221-32.
Gingival recession and plaque control. Compendium. 1987; 8(3): 194-8.
Gingival phenotypes in young male adults. J Clin Periodontol. 1997; 24(1):65-71.
Significance of the width of keratinized gingiva on the periodontal status of teeth with submarginal restorations. J Periodontol. 1987; 58(10):696-700.
Periodontal esthetics and soft-tissue root coverage for treatment of cervical root caries. Compend Contin Educ Dent. 1999;20(11):1043-6, 1048-50, 1052.
Proceedings of the World Workshop in Periodontics. In: Annals of periodontology. Chicago: The Academy; 1996.
Coronal positioning of a previously placed autogenous gingival graft. J Periodontol. 1977; 48(3):151-5.
Guided tissue regeneration in mucogingival surgery. J Periodontol. 1993;64(11 Suppl):1184-91.
A surgical procedure for the treatment of localized gingival recession in conjunction with root surface citric acid conditioning. J Periodontol. 1980; 51(9):505-9.
Significant differences and advantages between the full thickness and split thickness flaps. J Periodontol. 1974; 45(6):421-5.
Subepithelial connective tissue grafts in treatment of gingival recessions. A comparative study of 2 procedures. J Periodontol. 1994; 65(10):929-36.
Covering localized areas of root exposure employing the “envelope” technique. J Periodontol. 1985; 56(7):397-402.
Use of the supraperiosteal envelope in soft tissue grafting for root coverage. I. Rationale and technique. Int J Periodontics Restorative Dent. 1994; 14(3):216-27.
A classification of marginal tissue recession. Int J Periodontics Restorative Dent. 1985; 5(2):8-13.
Connective tissue grafting employing the tunnel technique: a case report of complete root coverage in the anterior maxilla. Int J Periodontics Restorative Dent. 2001; 21(1):77-83.
Mucogingival therapy—periodontal plastic surgery. In: Lindhe J, Karring T, Lang NP, editors. Clinical periodontology and implant dentistry. 5th ed. Oxford, UK: Blackwell Munksgaard; 2008. p. 955.
Treatment of multiple adjacent gingival recessions with the tunnel subepithelial connective tissue graft: a clinical report. Int J Periodontics Restorative Dent. 1999; 19(2):199-206.
