Aim To compare the clinical efficacy and postoperative morbidity of de‐epithelialized gingival graft (DGG) with subepithelial connective tissue graft (SCTG) on treatment of multiple adjacent gingival recessions (MAGRs) with tunnel technique (TUN) and to evaluate histological characteristics of the palatal grafts. Materials and methods Twenty‐seven patients with MAGRs affecting at least 2 adjacent teeth were treated with either DGG + TUN or SCTG + TUN. Recession depth(RD) and width(RW), probing depth(PD), clinical attachment level(CAL), keratinized tissue height(KTH), gingival thickness(GT), and complete and mean root coverage(CRC, MRC) were evaluated at 6 and 12 months postoperatively. Multilevel analysis was performed to identify patient‐ and tooth/site‐related predictors for the 12‐month MRC outcomes. Postoperative patient morbidity and histological characteristics of palatal graft samples obtained during harvesting were investigated. Results At the 12‐month follow‐up, MRC was 91.72% ± 16.59% and 84.72% ± 19.72% in DGG + TUN and SCTG + TUN groups (p = .001). Multilevel regression analysis identified RD, KTH and GT as variables associated with MRC. No significant difference between the groups was observed regarding postoperative patient morbidity parameters. Cellularity was found significantly higher in the SCTG samples compared to the DGG samples (p < .05). Conclusions Although DGG + TUN presented higher MRC and CRC compared to SCTG + TUN in the treatment of MAGRs, treatment method was not a significant predictive factor for the amount of MRC outcomes while RD, KTH and GT were significant predictive factors.

Background: This article depicts a clinical case with 1 year follow-up in which de-epithelialized gingival graft (DGG) was used with the tunnel technique to treat multiple gingival recessions (GRs), and describes a technique used to intraoral de-epithelialization with diamond burr.Methods: A 45-year-old male patient was referred for evaluation and treatment of anterior maxillary multiple GRs. DGG with the tunnel technique was proposed to coverage of Cairo Recession Type I GRs on teeth #21 through #22 and an on tooth#23. Tunnel bed area had been prepared with microblades and tunnel knives. Donor are measured and de-epithelialized with diamond burs intraorally. After DGG harvested split cross-sectionally. The DGG was placed through the tunnel bed with auxillary sutures and sutured with vertical double-crossed technique.Results: Ten days after the surgical procedure, the tissue region was homogeneous where there is not uncovered DGG part, and clinically increased tissue thickness was observed. After 1 years of follow-up, the mean coverage 92.2%. Besides, increasing of tissue thickness was observed. Conclusion:Intraoral DGG using with the tunnel technique successfully for treatment of multiple GRs with an increase of the soft tissue thickness and gain aesthetic outcomes.

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BackgroundDental malocclusions may cause disruption in occlusal harmony, and destructive interferences during mandibular functional movements can be seen. Ideal occlusal contacts during dynamic mandibular movements may be crucial for preventing the occurrence of mid‐buccal gingival recession (mbGR). While determining mbGR risk factors in young adults, the effect of occlusal interferences on mbGR has not yet been focused on. Based on this gap, this field needs to be clarified with new studies.ObjectiveThe aim of this case–control study was to evaluate the relationships between the presence, extent and severity of mbGRs to dental malocclusions, occlusal interferences in anterior (AG) and lateral guidance (LG) and to determine the potential risk indicators in a young population.MethodsA total of 149 dental students were comprised and 70 of them presented mbGR(s) and 79 did not (18–25 years, 4553 teeth). Periodontal status was assessed with full mouth bleeding (FMBS) and plaque score (FMPS), probing depth, clinical attachment level, recession depth and keratinised tissue width (KTW) by a periodontist. Malocclusions and occlusal interferences were evaluated by an orthodontist. Logistic regression analyses provided data on the effect of occlusal interferences and the other indicators towards mbGR.ResultsThe mean of the number of teeth with mbGR(s) per subject was 4.3. The mean of the overall extent of teeth with mbGR(s) was 14.2%. FMBS, decreased KTW, self‐reported bruxism, group function occlusion, increased contact number of all teeth and only premolars/molars in AG or LG and Class III malocclusions were significantly associated with the presence of mbGR. Decreased KTW presenting mbGR in the mandible and non‐carious cervical lesion adjunct to mbGR significantly increased the odds of the severity of mbGR. Group function occlusion revealed higher mbGRs in premolar/molars than canine guided occlusion.ConclusionIncrease in the occlusal interferences in premolars/molars during lateral and anterior guidance may have an effect on the presence and severity of mbGR. Further studies should be designed to confirm these findings.