Triangular coronally advanced flap: Conventional versus Microsurgery

Abstract

Several surgical techniques including pedicle flaps and free soft-tissue grafts have been indicated for the treatment of gingival recession defects with different success rates. Localized gingival recessions can be managed with various root coverage procedures, more specifically, using the coronally advanced flap with distinct designs. Predictable and consistent periodontal plastic surgical results can be achieved by using microsurgical instruments. Periodontal microsurgery involves the use of magnifying devices, microsurgical instruments, and materials in existing basic surgical techniques. It offers definitive advantages in terms of predictability, postoperative morbidity, and patient approval. This case report aims at comparing the modified approach with a triangular type of coronally advanced flap, using conventional and microsurgical approach, for treating bilateral isolated Miller's class I defect in both the maxillary canines by a split-mouth design.

Keywords: Coronally advanced flap; gingival recession; periodontal microsurgery; root coverage.

Figure 1

Preoperative clinical view of 23

Figure 2

Preoperative clinical view of 13

Figure 3

Orthodontic wire placed along the cementoenamel junction and tip of papillae marked (23)

Figure 4

Orthodontic wire moved to the gingival margin and oblique incisions marked (23)

Figure 5

Flap elevation with de-epithelization of interdental papillae (23)

Figure 6

Flap coronally advanced and sutured (23)

Figure 7

One-week postoperative: Sutures removed (23)

Figure 8

Flap elevation with de-epithelization of interdental papillae (13)

Figure 9

Flap coronally advanced and sutured (13)

Figure 10

One-week postoperative: Sutures removed (13)

Figure 11

One-month postoperative clinical view (13)

Figure 12

Six months postoperative clinical view (13)

Figure 13

One month postoperative clinical view (23)

Figure 14

Six months postoperative clinical view (23)