Modified double papillae flap technique: a new surgical approach for the treatment of isolated gingival recession defects. A case series

Aim: There have been no modifications made to the original double papillae flap surgical technique introduced by Cohen and Ross in 1968. The aim of the present case series is to evaluate the effectiveness of a modified surgical approach to the double papillae flap design in the treatment of isolated gingival recession. Materials and methods: A total of 12 healthy, young patients (age range 20 to 28 years) with isolated gingival recession were enrolled in this study. The gingival recession had the following characteristics: isolated defect, Miller Class I or II defect, visible cementoenamel junction (CEJ), and well represented interdental papillae. The following clinical measurements were taken before the surgery and at the 1-year follow-up examination: probing depth (PD) at the treated tooth, clinical attachment level (CAL), amount of keratinized tissue (KT) at the treated site, and recession depth (RD). All measurements were taken at baseline and after 12 months by means of a manual probe and were rounded up to the nearest millimeter. Results: At the 1-year follow-up examination, the same clinical parameters taken at baseline were rerecorded. No statistical differences were noted for the PD (P = 0.54). The mean increase for the CAL was statistically significant (P = 0.04). Furthermore, the mean amount of KT increased by 2.5 ± 0.4 mm (P 0.001). Finally, the mean RD decreased to 0.5 ± 0.6 mm, corresponding to a root coverage of 3.8 ± 0.8 mm (P 0.001). In terms of mean root coverage (MRC), 88.4% of exposed root surface was covered with soft tissue, and 9 of the 12 treated teeth (75%) showed complete coverage of the root surface. Conclusion: The results of the present case series show that the modified double papillae flap technique is effective in obtaining root coverage of isolated gingival recession defects. These rootcoverage outcomes were associated with clinically and statistically highly significant clinical attachment gain, with no noticeable change in either the PD values or the height of KT on the buccal aspect of the treated teeth.