A Novel Approach for Treatment of Two Adjacent Gingival Recession Defects using Modified Bilateral Pedicle Flap and Tunnel Technique combined with TitaniumPrepared Platelet Rich Fibrin

Abstract

Gingival recession being the most common mucogingival problem among adult patients is often associated with root hypersensitivity, erosion, root caries, and compromised aesthetics. The primary goal of treating gingival recession include complete root coverage along with improving gingival biotype to facilitate proper plaque control, improve patient aesthetics, and to prevent further periodontal breakdown. Although numerous root coverage techniques and regenerative materials are available, a novel technique involving the bilateral pedicle flap with subperiosteal tunnel in interdental papilla along with use of Titanium Prepared Platelet-Rich Fibrin (T-PRF) has been described in this case report. A 20-year-old male patient reported with the chief complaint of teeth sensitivity in lower front teeth. Intraoral examination revealed Recession Type 1 (RT-1) defects in mandibular central incisors which were treated using modified bilateral pedicle flap and tunnel technique combined with T-PRF. This technique allowed excellent blood supply at recipient site along with complete coverage of T-PRF membrane and root surfaces. The subperiosteal tunnel created in between the two affected teeth, allowed better stabilisation of membrane and inhibited apical retraction of flap during healing phase. Using this novel technique, complete root coverage was achieved along with gain in gingival thickness hence, it can be considered as a predictable approach for the treatment of RT-1 defects involving two adjacent teeth.