Modified multiple papilla full flap combined with tunneling and de-epithelialized gingival graft to manage severe gingival recession in mandibular incisors: literature review and case report

Gingival recession is a common condition in adults, causing esthetic issues or tooth sensitivity in patients. Gingival recession in the lower incisors area after orthodontic treatment is often difficult to predict, due to anatomical factors such as thin phenotype, shallow vestibular depth, and low frenum attachment. A young male patient presented to the clinic with severe Cairo Class I gingival recession at tooth 41 after 2 years of orthodontic treatment. Surgery combining tunneling technique and multiple papilla full thickness flap was performed to treat the patient after endodontic treatment. The clinical case was followed up to monitor gingival margin recovery one year post-surgery. The clinical case introduces a treatment method for severe localized gingival recession in the lower anterior region of a single tooth.