Dr. Otto Zuhr, Munich/Germany, demonstrates the coverage of gingival recession defects in the anterior maxillary area using the modified tunnel technique. Dr. Zuhr provides a detailed, step-by-step demonstration of the procedure and offers useful tips for the practitioner. In this presentation, Dr. Zuhr demonstrates the coverage of gingival recession defects on tooth 22 and 23 with a coronally advanced flap in connection with a connective tissue graft. To begin with, the exposed root surfaces are thoroughly cleaned. Then, an intrasulcular incision is made on the facial side of the teeth in question and their neighboring teeth preserving the tips of the papillae. A split thickness flap is prepared beyond the mucogingival junction. This is followed by the careful elevation and complete mobilization of the papillae using an angled tunnelling instrument.
In this case, a connective tissue graft is needed in order to increase the thickness of the buccal tissue. After the graft is harvested from the palate, the palatal wound is closed with sutures to achieve primary healing and in the end covered with a palatal splint. Carefully the tissue implant is pulled and pushed through until it is fully positioned within the gingival tunnel. Dr. Zuhr secures the graft and flap in the coronally advanced position with sutures that are guided over the interproximal alveolar bone.