Coronally advanced flap combined with connective tissue grafts for the treatment of mandibular anterior teeth gingival recession

To compare the effect of the combined coronally advanced flap and connective tissue flap techniques with that of a guided tissue regeneration (GTR) technique on recovering the exposed root surface in a case of gingival retraction over the lower anterior teeth.

A case of gingival recession (Miller Ⅲ type) over teeth 33-43 accompanied by hypersensitivity of the right lower teeth was treated using different techniques bilaterally. Teeth 42-43 were treated by a combined coronally advanced flap and connective tissue flap technique, while teeth 33-41 were treated by a GTR technique of a coronally advanced flap combined with an absorbable collagen membrane.

Teeth 42-43 exhibited ideal gingival recovering of the exposed root surface, with the disappearance of the hypersensitivity symptoms, during the follow-up visits at 3.5 months after surgery. However, the exposed root surface of teeth 33-41 exhibited no significant change in coverage at the same time points compared with the preoperative coverage. At 12 months after surgery, the recovered gingiva on the root surface of teeth 42-43 was stable.

The combined coronally advanced flap and connective tissue flap approach, which can achieve better coverage of the exposed root surface than the GTR technique, is a feasible and safe surgical method for treating cases with gingival recession. The GTR technique is not an effective method for treating cases with Miller Ⅲ type gingival recession over multiple teeth due to proximal attachment loss.