Minimally-Invasive Approaches for Multiple Tooth Recession

Monday, Oct. 29
10:45 a.m. - 12:15 p.m.

Program Track: Periodontal Plastic and Soft Tissue Surgery
Moderator: Edward P. Allen
Speakers: John Chao, Jim Janakievski, and Homa H. Zadeh

Multiple gingival recession (MGR) defects remain a therapeutic challenge, approached through an array of therapeutic options. Selection of therapeutic modality is often based on a clinician’s preference and experience. In recent years, a great deal of evidence has accumulated for the benefits of tunneling to avoid flap reflection. Traditionally, most of the tunneling has been performed through the gingival sulcus of teeth. However, vestibular tunneling presents a few options which may facilitate the treatment of multiple gingival recession defects. An important consideration has been suturing methods to stabilize the gingival margins during healing and prevent relapse. Some of the biologic principles and available evidence for the treatment of multiple gingival recession defects will be reviewed to highlight the possibilities and limitations of MGR therapy.

In regards to the apical tunnel technique, the most current results of an ongoing study comparing the apical tunnel approach with the subepithelial connective tissue graft at the University at Buffalo, SUNY. Today, there are multiple techniques, materials, instruments, and protocols available for tunnel flap procedures. The clinician must choose the best approach for treatment based on patient needs, clinical skills, site anatomy, and available scientific evidence. Through customization of treatment for the patient, optimal outcomes can be achieved.

Educational Objectives:
• Consider the evolution of tunnel flap procedures.
• Explain the surgical considerations when preparing a tunnel flap.
• Evaluate risk assessment and evidence for MGR therapy.
• Discuss vestibular tunneling: rationale and technique for MGR therapy.
• Review guidelines for graft material selection: autogenous donor tissue, allograft, xenograft, platelet-fibrin, and growth factors.
• Obtain the essentials of the apical tunnel approach protocol.
• Review the long-term results and most current research on the apical tunnel.