Treatment of gingival recession in the anterior mandible using the tunnel technique and a combination epithelialized-subepithelial connective tissue graft-a case series.

Covering exposed roots becomes more and more difficult as the gingiva becomes thinner and the vestibule becomes more shallow. Also, the outcome becomes less predictable. In addition, where there is high frenal attachment or muscle pull, such as the mentalis muscle in the mandibular anterior region, secondary retraction of a coronally advanced flap will likely occur. Therefore, a transplanted connective tissue graft may not completely cover the recession. This case series presents a technique where the roots are covered with a combination epithelialized-subepithelial connective tissue graft. The epithelialized portions of the graft are positioned directly over the exposed roots to aid in resistance to the environment of the mouth, and there is no displacement of the mucogingival junction or flattening of the vestibule.