Failure to consider the effects of aspirin on BOP could impair proper diagnosis and treatment planning for clinicians and introduce a significant confounding variable in research situations.

PurposeA laterally positioned flap (LPF) combined with a subepithelial connective tissue graft (SCTG) is one of the conventional approaches for resolving gingival recession defects, with the advantages of flap flexibility and extended coverage of the tissue graft. However, thus far, evidence is lacking for the use of this technique for the treatment of advanced gingival recession defects. This report discusses three Miller class III cases with interproximal bone loss and wide and deep defects treated with a combination procedure of a modified laterally positioned flap (mLPF) and SCTG.MethodsmLPF combined with SCTG was performed for each case. The defect size and the degree of hypersensitivity at baseline and the final appointment in each case were documented.ResultsThe three cases had a mean initial defect of 7.7±1.5 mm and a mean residual defect of 1.7±1 mm at the 6-, 3-, and 36-month follow-up, respectively, after the root coverage surgery. The symptom of hypersensitivity was improved, and the patients were satisfied with the clinical outcomes.ConclusionsThe results demonstrated that the combination of mLPF with SCTG is promising for treating these advanced cases with respect to obtaining the expected root coverage with the gingival tissue.Graphical Abstract

Introduction This case report documents root coverage after using an acellular dermal matrix (ADM) combined with a tunneling procedure. The photographs and objective clinical measurements are presented to document a gain of new clinical attachment and subsequent creeping attachment. Case Presentation A 50‐year‐old male who demonstrated around 6 mm of recessions on the direct facial of teeth #6 through #11 had a root coverage procedure using an ADM. After 24 months, >90% of the recession defects at all sites were eliminated. It was noted that creeping clinical attachment began to appear 6 months after initial therapy on teeth #7 through# 11. Conclusion The delayed creeping attachment seems to be due to the time necessary to vascularize the ADM and the rate of vascularization may vary with different thicknesses of inserted ADM.