Coronally Advanced Flap Associated with a Connective Tissue Graft for the Treatment of Multiple Recession Defects in Mandibular Posterior Teeth

The coronally advanced flap has been documented as an effective surgical technique for the treatment of gingival recessions in cases of multiple adjacent recession defects, obtaining stable long-term results after 5 years of follow-up. The aim of the present study was to test the coronally advanced flap, in association with a connective tissue graft, in a case series of 10 patients presenting at least two gingival recessions on adjacent teeth in the posterior mandibular area. Periodontal parameters were recorded on teeth involved in the surgeries at baseline and 1 year. A total of 26 recessions were treated. No significant complication affected the surgeries, and no patient abandoned the study. Recession depth was reduced from 3.40 ± 0.83 mm at baseline to 0.28 ± 0.32 mm at the 1-year control, while differences in pocket depth were not significant. Keratinized tissue increased from 0.57 ± 0.46 mm to 3.05 ± 0.71 mm. Greater reductions in recession depth were observed in cases where the initial conditions were worse. A mean 91.2% ± 4.1% recession coverage was obtained. The coronally advanced flap in association with a connective tissue graft can be proposed as a valid therapeutic approach for multiple recession defects in mandibular posterior areas.