Extensive Multiple Adjacent Gingival Recessions Repaired In One Surgical Session

A practical two - incision CTG harvesting method can yield longer connective tissue graft (CTG) from the palatal mucosa, sufficient to cover multiple recessions in a single surgery. A 41-year-old male who does not smoke and has 10 Miller Class I-III adjacent recessions in the mandibular anterior area was treated effectively with a single surgical session using coronally advanced tunnel technique combined with CTG graft. After a follow - up period of 1.5 years, a high rate of complete root coverage, an increase in keratinized tissue width and thickness, and satisfactory soft tissue esthetics were achieved. Our case likely represents the highest number of recession sites treated in a single surgery. When using CTG-based techniques for root coverage in extensive multiple recessions, securing a graft of sufficient length is a key challenge. Current popular CTG harvesting methods typically yield grafts of limited size. This is especially true in Chinese dental clinics, where patients often have thin palatal soft tissue. In our case, the two - incision CTG harvesting technique provided a 3-to 4-cm-long CTG from one palatal side. Combining grafts from both palatal sides allowed for the repair of 8 - 9 recession sites in a single surgery. In fact, this technique can yield even longer grafts extending from the canine to the maxillary tuberosity. The two-incision long CTG harvesting procedure with the full-split coronally advanced tunnel technique may provide a versatile one-step procedure for treating the extended multiple adjacent gingival recessions.