Case Report
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Year 2024, , 252 - 259, 30.12.2024

K B Roshni , Neetha J Shetty

https://doi.org/10.7126/cumudj.1439645

Abstract

References

  • 1. Pini Prato G. Mucogingival deformities. Ann Periodontol. 1999;4(1):98–101.
  • 2. Glossary of Periodontal Terms - AAP Connect [Internet]. [cited 2022 Dec 1]. Available from: https://members.perio.org/libraries/glossary?ssopc=1
  • 3. Wolff J, Farré-Guasch E, Sándor GK, Gibbs S, Jager DJ, Forouzanfar T. Soft Tissue Augmentation Techniques and Materials Used in the Oral Cavity: An Overview. Implant Dent. 2016 Jun 1;25(3):427–434.
  • 4. Allen E. The Papilla Access Tunnel Technique for the Treatment of Shallow Recession and Thin Tissue in the Mandibular Anterior Region. Int J Periodontics Restorative Dent. 2020 Mar;40(2):165–169.
  • 5. Use of the supraperiosteal envelope in soft tissue grafting for root coverage. I. Rationale and technique - PubMed [Internet]. [cited 2022 Dec 1]. Available from: https://pubmed.ncbi.nlm.nih.gov/7995692/
  • 6. Papageorgakopoulos G, Greenwell H, Hill M, Vidal R, Scheetz JP. Root coverage using acellular dermal matrix and comparing a coronally positioned tunnel to a coronally positioned flap approach. J Periodontol. 2008 Jun;79(6):1022–1030.
  • 7. Zuhr O, Rebele SF, Schneider D, Jung RE, Hürzeler MB. Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivative for root coverage: a RCT using 3D digital measuring methods. Part I. Clinical and patient-centred outcomes. J Clin Periodontol. 2014;41(6):582–592.
  • 8. Wang Y, Stathopoulou PG. Tunneling Techniques for Root Coverage. Curr Oral Health Rep. 2019 Dec 1;6(4):237–243.
  • 9. Allen E. The Papilla Access Tunnel Technique for the Treatment of Shallow Recession and Thin Tissue in the Mandibular Anterior Region. Int J Periodontics Restorative Dent [Internet]. 2020 Mar [cited 2023 Nov 16];40(2):165–169. Available from: https://pubmed.ncbi.nlm.nih.gov/32032398/
  • 10. Koob TJ, Rennert R, Zabek N, Massee M, Lim JJ, Temenoff JS, et al. Biological properties of dehydrated human amnion/chorion composite graft: implications for chronic wound healing. Int Wound J. 2013 Oct;10(5):493–500.
  • 11. Cairo F, Rotundo R, Miller PD, Pini Prato GP. Root coverage esthetic score: a system to evaluate the esthetic outcome of the treatment of gingival recession through evaluation of clinical cases. J Periodontol [Internet]. 2009 Apr [cited 2023 Nov 16];80(4):705–710. Available from: https://pubmed.ncbi.nlm.nih.gov/19335093/
  • 12. Kassab MM, Badawi H, Dentino AR. Treatment of gingival recession. Dent Clin North Am [Internet]. 2010 Jan [cited 2023 Nov 16];54(1):129–40. Available from: https://pubmed.ncbi.nlm.nih.gov/20103476/
  • 13. Subbareddy B, Gautami P, Dwarakanath C, Devi P, Bhavana P, Radharani K. Vestibular Incision Subperiosteal Tunnel Access Technique with Platelet-Rich Fibrin Compared to Subepithelial Connective Tissue Graft for the Treatment of Multiple Gingival Recessions: A Randomized Controlled Clinical Trial. Contemp Clin Dent [Internet]. 2020 Jul 1 [cited 2023 Nov 16];11(3):249–255. Available from: https://pubmed.ncbi.nlm.nih.gov/33776351/
  • 14. Pradeep K, Rajababu P, Satyanarayana D, Sagar V. Gingival Recession: Review and Strategies in Treatment of Recession. Case Rep Dent [Internet]. 2012 [cited 2023 Nov 16];2012:1–6. Available from: /pmc/articles/PMC3467775/
  • 15. Arunachalam M, Pulikkotil SJ, Sonia N. Suppl-1, M4: Platelet Rich Fibrin in Periodontal Regeneration. Open Dent J [Internet]. 2016 May 12 [cited 2023 Nov 16];10(1):174. Available from: /pmc/articles/PMC4911731/
  • 16. Garg S, Arora SA, Chhina S, Singh P. Multiple Gingival Recession Coverage Treated with Vestibular Incision Subperiosteal Tunnel Access Approach with or without Platelet-Rich Fibrin - A Case Series. Contemp Clin Dent [Internet]. 2017 Jul 1 [cited 2023 Nov 16];8(3):464–468. Available from: https://pubmed.ncbi.nlm.nih.gov/29042736/
  • 17. Yaman D, Demirel K, Aksu S, Basegmez C. Treatment of Multiple Adjacent Miller Class III Gingival Recessions with a Modified Tunnel Technique: A Case Series. Int J Periodontics Restorative Dent [Internet]. 2015 Jul [cited 2023 Nov 16];35(4):489–497. Available from: https://pubmed.ncbi.nlm.nih.gov/26133138/
  • 18. Dani S, Dhage A, Gundannavar G. The pouch and tunnel technique for management of multiple gingival recession defects. J Indian Soc Periodontol [Internet]. 2014 Nov 1 [cited 2024 Jan 1];18(6):776. Available from: /pmc/articles/PMC4296465/
  • 19. Minimally invasive treatment of maxillary anterior gingival recession defects by vestibular incision subperiosteal tunnel access and platelet-derived growth factor BB - PubMed [Internet]. [cited 2024 Jan 1]. Available from: https://pubmed.ncbi.nlm.nih.gov/22140667/
  • 20. Gupta P, Gupta H. Comparative evaluation of envelope type of advanced flap with and without type I collagen membrane (NEOMEMTM) in the treatment of multiple buccal gingival recession defects: A clinical study. Indian J Dent [Internet]. 2014 [cited 2023 Nov 16];5(4):190. Available from: /pmc/articles/PMC4260384/
  • 21. Roy A, Mantay M, Brannan C, Griffiths S. Placental Tissues as Biomaterials in Regenerative Medicine. Biomed Res Int [Internet]. 2022 [cited 2024 Jan 1];2022. Available from: /pmc/articles/PMC9050314/
  • 22. Gupta A, Kedige SD, Jain K. Amnion and Chorion Membranes: Potential Stem Cell Reservoir with Wide Applications in Periodontics. Int J Biomater [Internet]. 2015 [cited 2024 Jan 1];2015. Available from: /pmc/articles/PMC4684856/
  • 23. Gulameabasse S, Gindraux F, Catros S, Fricain JC, Fenelon M. Chorion and amnion/chorion membranes in oral and periodontal surgery: A systematic review. J Biomed Mater Res B Appl Biomater [Internet]. 2021 Aug 1 [cited 2024 Jan 1];109(8):1216–1229. Available from: https://pubmed.ncbi.nlm.nih.gov/33354857/

Treatment Of Gingival Recession In The Mandibular Anterior Region With An Amnion Chorion Membrane Using The Papilla Access Tunnel Technique – 2 Clinical Case Reports

Year 2024, , 252 - 259, 30.12.2024

K B Roshni , Neetha J Shetty

https://doi.org/10.7126/cumudj.1439645

Abstract

The tunnel technique for root coverage and soft tissue augmentation in the mandibular anterior area can pose several challenges, including shallow recession, thin soft tissue, pronounced roots, and alveolar undercuts. These factors can complicate the surgical procedure and lead to poor outcomes. In this context, a papilla access technique has been developed to facilitate the preparation of the tunnel site and the placement of grafts under challenging anatomical conditions. This surgical access method is particularly useful in patients with minimal recession of the mandibular central incisors, where extending the tunnel to include the lateral incisors and canines is necessary for augmentation purposes. This approach offers improved surgical maneuverability for both site preparation and graft placement while minimizing the risk of perforation or trauma to delicate tissues. Overall, the papilla access technique represents a useful addition to the armamentarium of periodontal surgeons for root coverage in the mandibular anterior region and soft tissue augmentation procedures.

Keywords

Tunneling Papilla access tunnel technique Amnion membrane Chorion membrane Root coverage Gingival recession

Ethical Statement

Informed consent was obtained from the patient prior to the start of the treatment and for publication of this case report. Approval was obtained from the institutional ethics committee (Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education) on the 10th of March, 2023 with protocol reference number: 23001

References

  • 1. Pini Prato G. Mucogingival deformities. Ann Periodontol. 1999;4(1):98–101.
  • 2. Glossary of Periodontal Terms - AAP Connect [Internet]. [cited 2022 Dec 1]. Available from: https://members.perio.org/libraries/glossary?ssopc=1
  • 3. Wolff J, Farré-Guasch E, Sándor GK, Gibbs S, Jager DJ, Forouzanfar T. Soft Tissue Augmentation Techniques and Materials Used in the Oral Cavity: An Overview. Implant Dent. 2016 Jun 1;25(3):427–434.
  • 4. Allen E. The Papilla Access Tunnel Technique for the Treatment of Shallow Recession and Thin Tissue in the Mandibular Anterior Region. Int J Periodontics Restorative Dent. 2020 Mar;40(2):165–169.
  • 5. Use of the supraperiosteal envelope in soft tissue grafting for root coverage. I. Rationale and technique - PubMed [Internet]. [cited 2022 Dec 1]. Available from: https://pubmed.ncbi.nlm.nih.gov/7995692/
  • 6. Papageorgakopoulos G, Greenwell H, Hill M, Vidal R, Scheetz JP. Root coverage using acellular dermal matrix and comparing a coronally positioned tunnel to a coronally positioned flap approach. J Periodontol. 2008 Jun;79(6):1022–1030.
  • 7. Zuhr O, Rebele SF, Schneider D, Jung RE, Hürzeler MB. Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivative for root coverage: a RCT using 3D digital measuring methods. Part I. Clinical and patient-centred outcomes. J Clin Periodontol. 2014;41(6):582–592.
  • 8. Wang Y, Stathopoulou PG. Tunneling Techniques for Root Coverage. Curr Oral Health Rep. 2019 Dec 1;6(4):237–243.
  • 9. Allen E. The Papilla Access Tunnel Technique for the Treatment of Shallow Recession and Thin Tissue in the Mandibular Anterior Region. Int J Periodontics Restorative Dent [Internet]. 2020 Mar [cited 2023 Nov 16];40(2):165–169. Available from: https://pubmed.ncbi.nlm.nih.gov/32032398/
  • 10. Koob TJ, Rennert R, Zabek N, Massee M, Lim JJ, Temenoff JS, et al. Biological properties of dehydrated human amnion/chorion composite graft: implications for chronic wound healing. Int Wound J. 2013 Oct;10(5):493–500.
  • 11. Cairo F, Rotundo R, Miller PD, Pini Prato GP. Root coverage esthetic score: a system to evaluate the esthetic outcome of the treatment of gingival recession through evaluation of clinical cases. J Periodontol [Internet]. 2009 Apr [cited 2023 Nov 16];80(4):705–710. Available from: https://pubmed.ncbi.nlm.nih.gov/19335093/
  • 12. Kassab MM, Badawi H, Dentino AR. Treatment of gingival recession. Dent Clin North Am [Internet]. 2010 Jan [cited 2023 Nov 16];54(1):129–40. Available from: https://pubmed.ncbi.nlm.nih.gov/20103476/
  • 13. Subbareddy B, Gautami P, Dwarakanath C, Devi P, Bhavana P, Radharani K. Vestibular Incision Subperiosteal Tunnel Access Technique with Platelet-Rich Fibrin Compared to Subepithelial Connective Tissue Graft for the Treatment of Multiple Gingival Recessions: A Randomized Controlled Clinical Trial. Contemp Clin Dent [Internet]. 2020 Jul 1 [cited 2023 Nov 16];11(3):249–255. Available from: https://pubmed.ncbi.nlm.nih.gov/33776351/
  • 14. Pradeep K, Rajababu P, Satyanarayana D, Sagar V. Gingival Recession: Review and Strategies in Treatment of Recession. Case Rep Dent [Internet]. 2012 [cited 2023 Nov 16];2012:1–6. Available from: /pmc/articles/PMC3467775/
  • 15. Arunachalam M, Pulikkotil SJ, Sonia N. Suppl-1, M4: Platelet Rich Fibrin in Periodontal Regeneration. Open Dent J [Internet]. 2016 May 12 [cited 2023 Nov 16];10(1):174. Available from: /pmc/articles/PMC4911731/
  • 16. Garg S, Arora SA, Chhina S, Singh P. Multiple Gingival Recession Coverage Treated with Vestibular Incision Subperiosteal Tunnel Access Approach with or without Platelet-Rich Fibrin - A Case Series. Contemp Clin Dent [Internet]. 2017 Jul 1 [cited 2023 Nov 16];8(3):464–468. Available from: https://pubmed.ncbi.nlm.nih.gov/29042736/
  • 17. Yaman D, Demirel K, Aksu S, Basegmez C. Treatment of Multiple Adjacent Miller Class III Gingival Recessions with a Modified Tunnel Technique: A Case Series. Int J Periodontics Restorative Dent [Internet]. 2015 Jul [cited 2023 Nov 16];35(4):489–497. Available from: https://pubmed.ncbi.nlm.nih.gov/26133138/
  • 18. Dani S, Dhage A, Gundannavar G. The pouch and tunnel technique for management of multiple gingival recession defects. J Indian Soc Periodontol [Internet]. 2014 Nov 1 [cited 2024 Jan 1];18(6):776. Available from: /pmc/articles/PMC4296465/
  • 19. Minimally invasive treatment of maxillary anterior gingival recession defects by vestibular incision subperiosteal tunnel access and platelet-derived growth factor BB - PubMed [Internet]. [cited 2024 Jan 1]. Available from: https://pubmed.ncbi.nlm.nih.gov/22140667/
  • 20. Gupta P, Gupta H. Comparative evaluation of envelope type of advanced flap with and without type I collagen membrane (NEOMEMTM) in the treatment of multiple buccal gingival recession defects: A clinical study. Indian J Dent [Internet]. 2014 [cited 2023 Nov 16];5(4):190. Available from: /pmc/articles/PMC4260384/
  • 21. Roy A, Mantay M, Brannan C, Griffiths S. Placental Tissues as Biomaterials in Regenerative Medicine. Biomed Res Int [Internet]. 2022 [cited 2024 Jan 1];2022. Available from: /pmc/articles/PMC9050314/
  • 22. Gupta A, Kedige SD, Jain K. Amnion and Chorion Membranes: Potential Stem Cell Reservoir with Wide Applications in Periodontics. Int J Biomater [Internet]. 2015 [cited 2024 Jan 1];2015. Available from: /pmc/articles/PMC4684856/
  • 23. Gulameabasse S, Gindraux F, Catros S, Fricain JC, Fenelon M. Chorion and amnion/chorion membranes in oral and periodontal surgery: A systematic review. J Biomed Mater Res B Appl Biomater [Internet]. 2021 Aug 1 [cited 2024 Jan 1];109(8):1216–1229. Available from: https://pubmed.ncbi.nlm.nih.gov/33354857/
There are 23 citations in total.

Details

Primary Language English
Subjects Periodontics
Journal Section Case Reports
Authors

K B Roshni 0000-0001-8097-2800

Neetha J Shetty 0000-0001-8841-6235

Publication Date December 30, 2024
Submission Date February 20, 2024
Acceptance Date December 6, 2024
Published in Issue Year 2024

Cite

EndNote Roshni KB, Shetty NJ (December 1, 2024) Treatment Of Gingival Recession In The Mandibular Anterior Region With An Amnion Chorion Membrane Using The Papilla Access Tunnel Technique – 2 Clinical Case Reports. Cumhuriyet Dental Journal 27 4 252–259.

Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.


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