PMC4695641_01
Preoperative view.
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A 32-year-old male patient reported to the Department of Periodontics with the chief complaint of receding gums in lower front tooth region (Figure 1).
Miller's Class II recession with 4 mm wide defect.
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On examination, a 4 mm wide and 5 mm deep Miller Class II gingival recession was found in right mandibular central incisor (Figures 2 and 3).
Miller's Class II recession with 5 mm deep defect.
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On examination, a 4 mm wide and 5 mm deep Miller Class II gingival recession was found in right mandibular central incisor (Figures 2 and 3).
Tunnel preparation.
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The gingival recession defect site/recipient site was prepared by apical extension of the crevicular incision along the right mandibular central incisor with split thickness dissection of the facially located tissues up to the level of the vestibular incision so as to create a tunnel (Figure 4) using Number 15 BP blade.
Periosteal Pedicle Flap raised by incomplete fenestration.
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Care was taken not to remove the periosteal strip completely and to leave it attached to the bone and the rest of the surrounding periosteum at the contralateral end (Figure 5).
Periosteal Pedicle Flap placed on the area of recession via tunnel.
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Tetracycline HCl in a ratio of 100 mg/mL for 3 minutes. The area was thoroughly irrigated and the PPF was then repositioned vertically towards the recession area, passing through the tunnel (Figure 6).
Suturing done using 5-0 resorbable sutures.
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While the PPF was sutured to the recipient bed, the labial mucosa was sutured apically to the periosteum at the depth of the fenestration using resorbable 5-0 sutures (Vicryl, Ethicon) (Figure 7).
6-month postoperative view.
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The recipient site showed adequate coverage with minimal probing depths and a favourable esthetic result after 6 months (Figure 8).