Abstract:

 Objective · To observe the clinical outcomes of a modified laterally moved and coronally advanced flap combined with a connective tissue graft (CTG) for
the treatment of severe Miller class II or class Ⅲ isolated recession defects. Methods · Three patients with initial defect depths of more than 5 mm and malposition in some teeth were enrolled and underwent a modified laterally moved and coronally advanced flap combined with CTG. Recession depth (RD), keratinized tissue height (KTH) of both donor and adopted site, pocket depth (PD), and clinical attachment loss (CAL) at baseline and follow-up one-year after treatment were documented. Root coverage rate (RC) was calculated and visual analogue scale (VAS) was used to evaluate patient’s satisfaction degree. Results · The mean RDs at baseline and follow-up were (5.3±0.5) mm and (0.3±0.5) mm. The mean RC at follow-up was (93.3±9.4)％and two cases had complete root coverage. The KTHs at adopted and donor sites were (0.3±0.5) mm and (6.0±0.8) mm at baseline and (4.3±0.5) mm and (5.7±1.3) mm at follow-up, respectively. PD and CAL were decreased from (1.7±0.5) mm and (7.0±0.8) mm at baseline to (1.3±0.5) mm and (1.3±1.2) mm at follow-up, respectively. The VAS value was 9.0±0.8 and subjective evaluation of patients was improved significantly at one-year follow-up, including root sensitivity and aesthetics. Conclusion · The modified laterally moved and coronally advanced flap with CTG has ideal clinical outcomes and satisfaction degree for the treatment of patients with severe recession defects that lack keratinized tissue and combine with buccal malposition.

Key words: gingival recession, root coverage, laterally moved and coronally advanced flap, connective tissue graft, clinical outcome