The coronally advanced flap for the treatment of multiple recession defects: a modified surgical approach for the upper anterior teeth

OBJECTIVE: The aim of the study was to evaluate the clinical efficacy of a modification of the flap-design of the coronally advanced flap for the treatment of multiple gingival recessions affecting the anterior teeth in patients with aesthetic demands. METHODS: Six systemically and periodontally healthy subjects with multiple recession-type defects affecting the upper incisors and canines (recession depth < or = 2 mm) were enrolled in the study. All recessions fell into Miller class I or II. In each patient all present recessions were treated at the same surgical time with a modification of the coronally advanced flap technique. The clinical re-evaluation was made one year after the surgery. RESULTS: A total of 25 recessions (mean recession depth 2.84 +/- 1.0 mm) were treated. The mean number of gingival recessions treated in each subject was 4.1 (range 3 - 5). At the one-year examination, on average, 97% of the root surface was covered with soft tissue and 89% of the defects showed complete root coverage. Complete root coverage in all recessions was achieved in four out of the six (67%) treated patients. A statistically significant increase of keratinized tissue height (0.64 +/- 0.6 mm) was observed after one year. CONCLUSIONS: The frontal approach of the coronally advanced flap was effective for the treatment of multiple gingival recessions affecting the anterior teeth in patients with aesthetic demands, and these results were successful both in terms of root coverage and increase in keratinized tissue height.