{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T18:49:48Z","timestamp":1767984588941,"version":"3.49.0"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,5,8]],"date-time":"2021-05-08T00:00:00Z","timestamp":1620432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Adv Periodontics"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Root coverage of gingival recessions in the anterior mandible has limited predictability. Mandibular incisors often offers a thin phenotype, a lack of keratinized tissue and moreover a shallow vestibule with high labial frenum attachment. These conditions induce tensions on the surgical site in conventional coronally advanced flap (CAF) procedures and may compromise the complete root coverage. The purpose of this case report is to present a novel surgical technique for deep labial recessions on mandibular incisors, based on a modified tunnel technique with subepithelial connective tissue graft (CTG) in combination with simultaneous frenuloplasty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Presentation<\/jats:title><jats:p>A 20\u2010year\u2010old female patient was referred to the office for treatment of an isolated RT1 in Cairo classification buccal recession on #24 with a shallow vestibule. The design of the recipient site consisted of a full\u2010thickness modified tunnel preparation extending 4 mm bilaterally to the recession and beyond the crestal bone. A CTG was harvested from the palate and properly adapted to the root surface. The graft and flap were secured with single\u2010interrupted sutures and double\u2010crossed sutures to achieve complete root coverage. Frenuloplasty was then performed with a single incision in the bottom of the vestibule and careful sectioning of frenum fibers to release vestibular tensions. Complete root coverage was maintained at 5 years with completely satisfactory esthetic outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Treatment of single deep mandibular anterior recessions with a combined tunneled CTG approach in addition to frenuloplasty appears to lead to complete long\u2010term root coverage in one surgery with lasting esthetics results.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cap.10163","type":"journal-article","created":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T10:07:25Z","timestamp":1619690845000},"page":"155-160","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["New Surgical Approach for Mandibular Anterior Root Coverage by Modified Tunnel Technique With Simultaneous Frenuloplasty: Technical Description and 5\u2010Year Recall Case Report"],"prefix":"10.1002","volume":"11","author":[{"given":"Matthieu","family":"Rimbert","sequence":"first","affiliation":[{"name":"Private practice  Toulouse France"},{"name":"Department of Periodontology Paul Sabatier University  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronan","family":"Barr\u00e9","sequence":"additional","affiliation":[{"name":"Private practice  Vic Fezensac France"},{"name":"Department of Periodontology Paul Sabatier University  Toulouse France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,5,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.17-0733"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2010.100102"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2005.76.10.1758"},{"key":"e_1_2_10_5_1","first-page":"1","article-title":"Root coverage stability: a systematic overview of controlled clinical trials with at least 5\u2009years of follow\u2010up","author":"Bertl K","year":"2021","journal-title":"Clin Exp Dent Res"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1051\/odfen\/2018054"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2015.130674"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1975.tb01721.x"},{"key":"e_1_2_10_9_1","first-page":"24","article-title":"Modified two\u2010stage procedures for the treatment of gingival recession","volume":"8","author":"Zucchelli G","year":"2013","journal-title":"Eur J Esthet Dent"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2011.01732.x"},{"key":"e_1_2_10_11_1","first-page":"279","article-title":"A single\u2010incision technique to harvest subepithelial connective tissue grafts from the palate","volume":"19","author":"Hurzeler MB","year":"1999","journal-title":"Int J Periodontics Restorative Dent"},{"key":"e_1_2_10_12_1","first-page":"338","article-title":"A modified suture technique for plastic periodontal and implant surgery : the double\u2010crossed suture","volume":"4","author":"Zuhr O","year":"2009","journal-title":"Eur J Esthet Dent"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12269"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.11607\/prd.3680"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cap.10046"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/cap.10063"}],"container-title":["Clinical Advances in 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