Root coverage in class I gingival recession defects, combining rotated papillary pedicle graft and coronally repositioned flap, using a micro surgical approach: A clinical evaluation.

Background: The purpose of this case study was to evaluate the success and predictability of a rotated papillary pedicle graft in combination with the coronally advanced flap using surgical loupe (2.5X magnification) for the treatment of Miller's class I gingival recession.

Materials And Methods: Fifteen systemically healthy patients with isolated gingival recession underwent the procedure. The probing depth, percentage root coverage, width of the keratinized gingiva and the gain in clinical attachment, papilla width, papilla height, area of the papilla at the donor site, were recorded at baseline, 3 months and 12 months.

Results: All parameters except probing pocket depth, significantly improved from baseline to 12 months. The mean recession defect of 2.67 +/- 0.03 mm present at baseline reduced to 0.13 +/- 0.35 mm at the end of the 3(rd) months and stabilized at 0.27 +/- 0.59 mm at 12 months. The mean reduction in recession depth was 2.40 +/- 0.03 mm at the end of the study. Complete recession coverage was obtained in 13 of the 15 (87%) of the cases treated with a mean percentage recession coverage at 12 months being 86 +/- 35.19%. The gain in the width of the keratinized gingiva was 1.33 +/- 0.13 mm at the end of the study. There was no postoperative morbidity from where the graft was harvested at the end of the study period.

Conclusion: The use of magnification in mucogingival surgery resulted in achieving a high degree of success and predictability as well as an excellent esthetic outcome.