Combined Flap: A Novel Approach for Root Coverage- Report of three Cases

Gingival recession by definition is the location of marginal tissue apical to the cementoenamel junction. The increasing interests in esthetics and problems related to hypersensitivity associated with gingival recession have favored the development of many surgical techniques that permit coverage of the exposed roots. The aim of this case series is to present a new mucogingival surgical technique for root coverage with two types of flaps (Combined flap).

Three cases were treated by the technique described (Combined Flap). The first flap is partial thickness- epithelial connective tissue flap positioned over a second, double papilla connective tissue flap with underlying periosteum that is rotated to cover the root surface. The clinical parameters such as extent of recession depth, probing depth, width of keratinized tissue and gingival tissue thickness were measured before and three months post surgery.

Results revealed reduction in recession depth and appreciable increase in width of keratinized tissue and gingival tissue thickness. There was no difference in probing depth, gingival index and plaque index at base-line and postoperatively 3 months after surgery.

Combined Flap surgical approach for root coverage of isolated gingival recession type defects is promising and predictable with limited drawbacks. Further studies that compare the result of this technique with already established techniques are necessary to support its regular use.