Int J Stomatol

Int J Stomatol ›› 2025, Vol. 52 ›› Issue (3): 341-348.doi: 10.7518/gjkq.2025059

• Periodontal cases • Previous Articles    

Multiple adjacent gingival recessions using modified coronally advanced tunnel and double-cross suspension suture technique: a case report

Li Gao1,2(),Jiajia Cheng1,2,Ni Wang1,2,Song Ge1,2   

  1. 1.Dept. of Oral Medicine, School of Stomatology, Zunyi Medical University, Zunyi 563099, China
    2.Dept. of Periodontics, Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi 563099, China
  • Received:2024-09-24 Revised:2025-02-04 Online:2025-05-01 Published:2025-04-30
  • Contact: Li Gao E-mail:467278759@qq.com
  • Supported by:
    Science and Technology Cooperation Foundation of Zunyi [Zunshi Kehe HZ (2024) 347];National Clinical Key Specialty Construction Manuscript (Medical Administration Letter from the National Health Office [2023] 213)

RichHTML

0

PDF (PC)

4

Abstract:

This article reports a case of multiple adjacent gingival recessions (MAGR) treated with a modified coronally advanced tunnel (MCAT) technique combined with a subepithelial connective tissue graft (SCTG), utilizing a double-cross suspension suture technique. The patient primarily presents with Class Ⅰ and Class Ⅱ gingival recession at multiple tooth sites according to the Cairo classification. The treatment protocol involved initial periodontal nonsurgical therapy, followed by staged root coverage procedures using a minimally invasive MCAT technique with SCTG and double-cross suspension suture technique. Postoperative follow-ups at 12, 24, and 36 months demonstrated 100% root coverage, favorable aesthetic outcomes in terms of color match and contour, and stable long-term therapeutic results.

Key words: multiple adjacent gingival recession, root coverage, modified coronally advanced tunnel technology, double-cross suspension suture technique

CLC Number: 

  • R781.4

TrendMD: 

Fig 1

Initial oral examination, periodontal probing examination and imaging examination"

Fig 2

Oral examination and periodontal probing examination after 1 month of periodontal initial therapy"

Fig 3

Flowable resin to prepare the suspension suture point and preparation of tunnel access"

Fig 4

Obtainment of the connective tissue"

Fig 5

Connective tissue was placed into the tunnel and papillae gingiva was sutured by double cross suspension suture technique"

Fig 6

Immediately after surgery and gingiva of two weeks after the removal of the line"

Fig 7

The preoperative and postoperative comparison"

Fig 8

The preoperative and postoperative comparison of teeth 12 to 22 and 33 to 43"

1 Patel M, Nixon PJ, Chan MF. Gingival recession: part 1. Aetiology and non-surgical management[J]. Br Dent J, 2011, 211(6): 251-254.
2 Leonard RH Jr, Haywood VB, Phillips C. Risk factors for developing tooth sensitivity and gingival irritation associated with nightguard vital bleaching[J]. Quintessence Int, 1997, 28(8): 527-534.
3 Daprile G, Gatto MR, Checchi L. The evolution of buccal gingival recessions in a student population: a 5-year follow-up[J]. J Periodontol, 2007, 78(4): 611-614.
4 Jepsen S, Caton JG, Albandar JM, et al. Periodontal manifestations of systemic diseases and developmental and acquired conditions: consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Di-seases and Conditions[J]. J Periodontol, 2018, 89(): S237-S248.
5 Pini-Prato G, Franceschi D, Rotundo R, et al. Long-term 8-year outcomes of coronally advanced flap for root coverage[J]. J Periodontol, 2012, 83(5): 590-594.
6 Nickles K, Ratka-Krüger P, Neukranz E, et al. Ten-year results after connective tissue grafts and guided tissue regeneration for root coverage[J]. J Periodontol, 2010, 81(6): 827-836.
7 Molnár B, Aroca S, Dobos A, et al. Treatment of multiple adjacent RT 1 gingival recessions with the modified coronally advanced tunnel (MCAT) technique and a collagen matrix or palatal connective tissue graft: 9-year results of a split-mouth randomized clinical trial[J]. Clin Oral Investig, 2022, 26(12): 7135-7142.
8 Neves FLDS, Augusto Silveira C, Mathias-Santamaria IF, et al. Randomized clinical trial evaluating single maxillary gingival recession treatment with connective tissue graft and tunnel or trapezoidal flap: 2-year follow-up[J]. J Periodontol, 2020, 91(8): 1018-1026.
9 Sangiorgio JPM, Neves FLDS, Rocha Dos Santos M, et al. Xenogenous collagen matrix and/or enamel matrix derivative for treatment of localized gingival recessions: a randomized clinical trial. Part Ⅰ: clinical outcomes[J]. J Periodontol, 2017, 88(12): 1309-1318.
10 刘琦, 张海东. 牙周根面覆盖术[M]. 沈阳: 辽宁科学技术出版社, 2018: 146-158.
Liu Q, Zhang HD. Atlas of periodontal surgery for root coverage[M]. Shenyang: Liaoning Science and Technology Press, 2018: 146-158.
11 Caton JG, Armitage G, Berglundh T, et al. A new classification scheme for periodontal and peri-implant diseases and conditions-introduction and key changes from the 1999 classification[J]. J Clin Pe-riodontol, 2018, 45(): S1-S8.
12 Merijohn GK. Management and prevention of gingival recession[J]. Periodontol 2000, 2016, 71(1): 228-242.
13 Imber JC, Kasaj A. Treatment of gingival recession: when and how[J]. Int Dent J, 2021, 71(3): 178-187.
14 Miller PD Jr. A classification of marginal tissue recession[J]. Int J Periodontics Restorative Dent, 1985, 5(2): 8-13.
15 Cairo F, Nieri M, Cincinelli S, et al. The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: an explorative and reliability study[J]. J Clin Periodontol, 2011, 38(7): 661-666.
16 Zegarra-Caceres L, Orellano-Merluzzi A, Muniz FWMG, et al. Xenogeneic collagen matrix vs. connective tissue graft for the treatment of multiple gingival recession: a systematic review and meta-analysis[J]. Odontology, 2024, 112(2): 317-340.
17 Aroca S, Molnár B, Windisch P, et al. Treatment of multiple adjacent Miller Class Ⅰ and Ⅱ gingival recessions with a modified coronally advanced tunnel (MCAT) technique and a collagen matrix or palatal connective tissue graft: a randomized, controlled clinical trial[J]. J Clin Periodontol, 2013, 40(7): 713-720.
18 Cairo F. Periodontal plastic surgery of gingival recessions at single and multiple teeth[J]. Periodontol 2000, 2017, 75(1): 296-316.
19 戴安娜, 丁佩惠, 唐琪, 等. 牙周根面覆盖术治疗牙龈退缩的长期疗效观察[J]. 中华口腔医学杂志, 2019, 54(2): 124-129.
Dai AN, Ding PH, Tang Q, et al. Long-term stability of periodontal root coverage procedures for gingival recession[J]. Chin J Stomatol, 2019, 54(2): 124-129.
20 谢成婕, 刘小豪, 陈杰, 等. 根面覆盖术之隧道技术的研究进展[J]. 口腔疾病防治, 2023, 31(8): 533-542.
Xie CJ, Liu XH, Chen J, et al. Research progress on the tunnel technique for root coverage[J]. J Prev Treat Stomatol Dis, 2023, 31(8): 533-542.
21 Tavelli L, Barootchi S, Nguyen TVN, et al. Efficacy of tunnel technique in the treatment of localized and multiple gingival recessions: a systematic review and meta-analysis[J]. J Periodontol, 2018, 89(9): 1075-1090.
[1] Meilin Zhao,Yiqiong Zhao,Jiao Huang. Treatment of gingival papilla loss with gingival recession in orthodontic patients with stage Ⅲ grade C periodontitis: a case report [J]. Int J Stomatol, 2025, 52(3): 333-340.
[2] Zhang Chen1, Zhao Qi2, Qin Hongxia1. Treating MillerⅠ, Ⅱ gingival recession with coronally advanced flap [J]. Inter J Stomatol, 2012, 39(5): 639-641.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!