A Novel 3D Tunneling (3DT) Surgical Technique for the Treatment of Gingival Recessions with Reconstruction of the Deficient Interdental Papilla and Interproximal Attachment Regeneration: A Case Series.

Abstract

Current concepts in periodontology emphasize the interproximal attachment as an important distinguishing aspect with significant influence, making it a key diagnostic and prognostic factor. Complete regeneration of the interproximal clinical attachment has become a primary determinant of periodontal success. Since the mid-20th century, numerous articles have been published on root coverage procedures, mostly for nonproximal gingival recessions. When it comes to the interdental area, the literature does not inspire the same level of confidence. This case series introduces an innovative 3D tunneling surgical technique for gingival papilla reconstruction and supra-alveolar interproximal attachment regeneration. The technique is described step by step and shown with three selected clinical cases of multiple bilateral adjacent gingival recessions (types 2 and 3) in the anterior mandible with 6.5 years of follow-up. A total of 18 proximal, midbuccal, and midlingual recessions were treated simultaneously. Up to 88.9% of mean root coverage was achieved in the proximal area. Within its limits, this case series demonstrates the possibility of treating gingival recessions with deficient papillae in the anterior mandible, achieving a significant clinical improvement with long-term stability.