This case report presents a papillary reconstructive surgical procedure based on the use of a double subepithelial connective tissue pedicle graft (SCTPG) in conjunction with a coronally advanced tunnel flap (CATF), for root coverage of gingival recession defects (GRD) with interproximal tissue loss and adjacent collapsed papillae. Two GRD (teeth #13 and #12) with interproximal tissue loss and collapsed papillae were treated by means of a bilaminar approach, based on the use of a palatal double SCTPG, rotated and inserted into a palatal-buccal tunnel flap at the level of mesial and distal papillae of maxillary right lateral incisor, associated to a CATF. Seven months after surgery, complete root coverage was achieved in both GRD. Concerning the reconstruction of tooth’s #12 papillae, the distance from the contact point to the tip of distal and mesial papillae decreased from 5 mm to 2 mm and from 4 mm to 2 mm, respectively. Overall, the patient was highly satisfied with the yielded outcomes. Within the limits of this case report, it could be demonstrated that the double SCTPG + CATF promoted prominent clinical and esthetical improvements to the baseline conditions of both GRD and collapsed papillae.
Keywords: gingival recession, gingival surgery, connective tissue, papilla, esthetics, gingival reconstruction