Treatment of a recession defect using coronally and laterally advanced flaps with subepithelial connective tissue graft: a case report with a three-year follow-up

Background: This article describes a root coverage technique of a Miller class I and II recessions using a subepithelial connective tissue graft with a coronal and a lateral split thickness flaps. Methods: A 22-year-old female patient was referred for evaluation and treatment of 2 recessions on teeth number 32 and 33. Following basic therapy, a coronal advanced flap was used on tooth number 32 and a lateral advanced split thickness flap on tooth number 33 with a subepithelial connective tissue graft (SCTG) proposed to provide root coverage of Miller Class I and Class II. After preparation of the recipient site, a SCTG was harvested from palate; the graft was placed on the periosteum and covered by both split thickness flaps. Results: After 3 years, complete root coverage was noticed with increase in tissue thickness and gain of keratinized gingiva. Conclusion: At three years post-surgery, combination of two types of split thickness flaps with connective tissue graft technique seemed to be a predictable treatment for 2 types of adjacent recessions.