Journal of Prevention and Treatment for Stomatological Diseases ›› 2019, Vol. 27 ›› Issue (6): 341-349.doi: 10.12016/j.issn.2096-1456.2019.06.001

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Gingival recession and minimally invasive tunnel technique

Fuhua YAN(),Lingjun LI   

  1. Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
  • Received:2018-12-06 Revised:2019-01-27 Online:2019-06-20 Published:2019-06-21
  • Contact: Fuhua YAN E-mail:yanfh@nju.edu.cn

Abstract:

Gingival recession (GR) is characterized by exposure of the root surface into oral environment due to apical migration of the marginal gingiva to the cementoenamel junction (CEJ). A high prevalence of GR has been reported in several representative population samples. GR may result in a certain degree of functional and aesthetic alterations if left untreated for long periods. In severe cases, root-dentin hypersensitivity, abrasion, abfraction and root caries may also be involved in GR, which increases the challenge of plaque control. The etiology of GR is multifactorial, including periodontal disease, local anatomical variation, tooth malposition, improper tooth brushing, mechanical trauma and iatrogenic factors, of which periodontal disease is the most common cause. The treatments of GR consist of nonsurgical and surgical therapy, and the latter generally involves mucogingival surgery to restore the aesthetics and function of the local gingival recession. However, over the past 50 years, the periodontal plastic surgical technique has evolved from the traditional free gingival graft method into a more advanced, minimally invasive tunnel technique. For this technique, sulcular incisions instead of vertical relieving incisions are provided through each recession area, and full thickness mucoperiosteal flaps are created and extended beyond the mucogingival junction to facilitate coronal displacement. Each pedicle adjacent to the recession is gently undermined to create a tunnel at recipient site, where either autograft or allograft can be used. A minimally invasive tunnel technique is a better method for root coverage and reduced postoperative patient discomfort. This technique is characterized by both practical and aesthetic features.

Key words: Gingival recession, Mucogingival surgery, Minimally invasive, Tunnel technique, Periodontal surgery

CLC Number: 

  • R781.05

Figure 1

Gingival recession"

Figure 2

Miller′s classification of gingival recession"

Figure 3

Root exposure and caries"

Figure 4

Periodontitis and gingival recession"

Figure 5

Orthodontic tooth movement and gingival recession"

Figure 6

Free gingival graft"

Figure 7

Connective tissue graft"

Figure 8

Laterally positioned flap graft"

Figure 9

Coronally advanced flap"

Figure 10

Tunnel flap graft"

Figure 11

Minimally invasive tunneling combined with subepithelial connective tissue transplantation"

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