Background information
Dr. Sofia Aroca:
A 50 year old patient presented with multiple Miller Class 2 recessions in the right maxilla. His
chief complaint was root sensitivity. Preoperative pocket depths, recession and recession width
were measured:
Pocket depth (mm)
Recession (mm)
Recession width (mm)
Tooth 24
0.5
2
5
Tooth 25
1
2
5
Tooth 26
2
3
10
The patient is treated with Geistlich Mucograft ® as an alternative to a connective tissue graft.
For a successful outcome, it is critical that the flap and the matrix are fully stabilized in an adequate
coronally advanced position.
A strict postoperative care management is recommended. This means:
– suitable analgesia
– mouth rinsing with 0.2% CHX twice a day during 15 days
– no tooth brushing during 15 days post-operatively on the operated site
– brush teeth with a surgical tooth brush after 15 days post-operatively on the operated area.
2. Aims of the therapy
> Using the coronally advanced modified tunneling technique (CAMT) with Geistlich Mucograft ® as
an alternative to the standard connective tissue graft procedure.
> The aim of the surgery is the complete coverage of the root and stable results in the long term.
3. Surgical procedure
Fig. 1 Initial situation. Fig. 2 Root planning with a Gracey currette before
the incision is made. The procedure is finished
when the soft-tissue structure is removed and the
root surface feels hard. Fig. 3 Gingival displacement in the vertical dimension
is measured using a periodontal probe.
Fig. 4 Gingival displacement in the horizontal
dimension is measured using a periodontal probe. Fig. 5 The intrasulcular incision is performed with a
curved tunneling knife. The instrument is kept conti-
nuously in contact with the bony surface to avoid the
risk of soft tissue perforation. The mucoperiosteal
pouch is elevated just past the mucogingival junction. Fig. 6 After finishing the tunnel preparation, the
papillae are elevated from the interdental bone
with a papilla elevator.
2