Modified semilunar coronally advanced flap.

BACKGROUND

Correction of mucogingival recession deformities with a variety of periodontal plastic surgery procedures has been described, each demonstrating a variable degree of success. A modified semilunar coronally advanced flap is described for the treatment of recession defects on multiple adjacent teeth.

METHODS

Semilunar incisions were made apical to the recession defects, starting within mucosa and extended mesio-distally, arching more coronally to terminate apical to the papillae mesial and distal to the teeth exhibiting the defects. The papilla between the teeth with recession was coronally advanced after a split-thickness dissection and sutured more coronally, over the deepithelialized portion of the original papilla. The flap design gave better mobility and stability to the repositioned pedicle than previously described semilunar coronally advanced flap procedures.

RESULTS

Seven cases treated with this approach healed without complication and remained stable throughout the 8 to 22 months of post-surgical observation.

CONCLUSIONS

This technique will be particularly valuable when previous attempts for root coverage with soft tissue autografts have resulted in residual recession defects on adjacent teeth and in a thicker-tissue biotype that would be amenable to partial-thickness dissection. An adequate thickness of tissue that will allow a partial-thickness flap dissection is required to avoid tooth or alveolar bone fenestrations. This technique provides better control over flap repositioning than previously described semilunar coronally advanced flaps.