Uso da técnica do túnel fechado lateralmente e do enxerto gengival livre no tratamento de recessões gengivais unitárias na mandíbula: Relato de casos

Abstract

Free gingival grafting (FGE) is a simple technique considered the most effective procedure to obtain gingival augmentation in sites with a minimal amount of keratinized gingiva. However, the lack of chromatic integration and unsatisfactory texture of the graft after healing prevent its use in areas with high aesthetic demands. In this context, the laterally closed tunnel technique has been proposed as an alternative to the use of EGL in the treatment of single gingival recessions (RG) in the mandible. This case report aimed to present two case reports to describe the laterally closed tunnel technique and the EGL technique in the treatment of single GR in the anterior region of the mandible. Two female participants with isolated Miller Class I [Recession Type (RT) 1] GR in the anterior mandible were included. Regarding the treatment of GR, the laterally closed tunnel technique was used (Case 1) or the EGL (Case 2). For the laterally closed tunnel technique, the de-epithelialized gingival graft was used. Periodontal clinical parameters were evaluated in the recipient area at baseline and after 1, 3, 6 and 12 months postoperatively for both cases. The visual analogue scale (VAS) for pain and aesthetics were used to assess the participant's perception of the treatment used. Regarding the height of the gingival recession, partial root coverage was obtained in both cases, 71.4% in the laterally closed tunnel technique (Case 1) and 75% in the EGL (Case 2). In both cases, the absence of keratinized gingiva was observed at the beginning of the treatment, and a greater gain in height of keratinized gingiva was obtained with the EGL (7mm) compared to the laterally closed tunnel technique (3mm). With regard to the aesthetic evaluation, the laterally closed tunnel technique presented superior results compared to the EGL. It was concluded that both cases had partial root coverage, with the tunnel technique providing better aesthetic standards in case 1 and the free gingival graft ensuring greater gain in height of keratinized gingiva in case 2.