Long-term assessment of a modified tunneling technique for root coverage in lower anterior gingival recession: a retrospective study.

Purpose: Root coverage (RC) procedures require long-term evaluation. This study assessed the clinical validity and long-term stability of a modified tunneling technique for lower anterior gingival recession (GR) using a subepithelial connective tissue graft (SCTG) and a volume-stable collagen matrix.

Methods: Across 39 patients, 66 mandibular incisors with ≥1.0 mm of GR were examined before and after RC surgery. Clinical photographs documenting the results of RC were taken at baseline (T₀) and the most recent follow-up visit (T). Impressions were obtained either at baseline (T₀) or 3 weeks later (T₃). The recession depth, Miller classification, and rates of RC and complete root coverage (CRC) were assessed.

Results: This study analyzed 66 GR sites across 39 patients, with an average follow-up period of 41.3 months. Overall, the mean RC achieved was 86.2%±15.7%. Among single recessions, the RC was 85.2%±25.6% for Miller class I, 91.5%±10.4% for class II, and 79.2%±18.3% for class III. Regarding multiple recessions, the RC was 85.1%±16.2% for Miller class I, 87.0%±12.5% for class II, and 89.8%±16.0% for class III. By Miller classification, the RC was 85.1%±16.8% for class I, 88.7%±11.6% for class II, and 85.8%±17.3% for class III. Furthermore, the RC varied by follow-up duration: 72.5%±15.1% at 12 months, 90.1%±12.6% at 25-36 months, 89.0%±16.7% at 37-48 months, 91.10%±9.88% at 49-60 months, and 97.6±4.79% for longer than 61 months, with 77.8% of the last group achieving CRC. RC also differed based on the initial recession depth, at 88.0%±16.8% for 1-3 mm, 83.1%±14.1% for 3-6 mm, and 80.2%±5.04% for depths exceeding 6 mm.

Conclusions: A modified tunneling technique, utilizing SCTG and a volume-stable collagen matrix, appears to represent a reliable option for the long-term management of GR in the lower anterior region, even in cases involving multiple Miller class III GRs.