Management of multiple adjacent gingival recession defects using pouch & tunnel technique with different inter-positional materials– A report of two cases

Abstract

Gingival recession is defined as the apical displacement of the marginal gingiva in relation to the cemento-enamel junction. It is a common clinical finding in individuals with good as well as those with a poor oral hygiene. It may affect a single tooth or multiple teeth simultaneously. Patients with multiple adjacent gingival recessions present as a major therapeutic challenge to the Periodontist, when it comes to balancing their esthetic and functional demands. Multiple adjacent gingival recession defects are associated with an extensive avascular surface. Furthermore, the clinician has to deal with the underlying anatomical factors such as thin gingival biotype, root prominence, root proximity and sub-optimal width of keratinized tissue. These factors make selection of surgical modality of treatment much more complex in contrast to the localized gingival recession defects. In the current report, we present two such cases of multiple adjacent gingival recession defects, managed by pouch and tunnel technique, using two different inter-positional materials namely the connective tissue graft and platelet rich fibrin.