{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:59:28Z","timestamp":1792036768276,"version":"4.4.0"},"reference-count":142,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Over the past several decades, periodontal plastic surgery has undergone a remarkable transformation, particularly in the field of root coverage procedures. This review traces the historical evolution of surgical techniques, from the early use of pedicle flaps and free gingival grafts (FGGs) to the development of bilaminar approaches incorporating subepithelial connective tissue grafts (SCTGs). Each stage of innovation has contributed to improved predictability and enhanced esthetic outcomes, while also aiming to reduce patient morbidity.<\/jats:p>\n                    <jats:p>The introduction and continuous evolution of the coronally advanced flap (CAF) marked a significant advancement, progressively improving the consistency and predictability of complete root coverage. Later developments, such as tunneling techniques (TUNs), emphasized minimally invasive flap preparation, preservation of vascular supply, and improved esthetics. These principles were ultimately combined in approaches such as the tunneled coronally advanced flap (TCAF), a versatile technique that merges the strengths of both CAF and TUN, with the focus on the specific features of the site and its local anatomy. This review also highlights how clinical insights, surgical refinements, and biologic understanding have shaped modern flap designs, graft handling, and treatment planning. With the growing demand for esthetic outcomes and individualized care, future directions in root coverage surgery are expected to include further refinement of flap designs, integration of injectable biologics and biomaterials, and the implementation of patient\u2010 and site\u2010specific protocols. By revisiting the historical foundations and innovations that have defined root coverage surgery, this review underscores the importance of technique selection and customization in achieving optimal clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain language summary<\/jats:title>\n                    <jats:p>Over the years, gum surgery for covering gingival recessions has improved significantly. This review looks at how techniques have evolved\u2014from early methods to more advanced ones using a connective tissue graft obtained from the roof of the mouth. These innovations have made results more reliable, more natural\u2010looking, and easier on patients. A major step forward was the so\u2010called \u201ccoronally advanced flap (CAF),\u201d which improved how well and consistently roots could be covered. Later, \u201ctunneling techniques (TUNs)\u201d were introduced to be less invasive and to better preserve blood supply. Eventually, these ideas were combined in a newer approach called the \u201ctunneled coronally advanced flap (TCAF),\u201d which adapts to the specific shape and needs of each treatment site. This review highlights the key modifications and innovations proposed over the years that have shaped the development of various surgical approaches for root coverage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jper.70044","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T10:38:27Z","timestamp":1769423907000},"page":"983-1009","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Tracing the evolution of root coverage: Clinical milestones leading to a minimally invasive era"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4864-3964","authenticated-orcid":false,"given":"Lorenzo","family":"Tavelli","sequence":"first","affiliation":[{"name":"Department of Oral Medicine Infection, and Immunity Division of Periodontology Harvard School of Dental Medicine  Boston Massachusetts USA"},{"name":"School of Dentistry Universidad Catolica de Guayaquil  Guayaquil Ecuador"},{"name":"Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION) Boston Massachusetts USA"},{"name":"Department of Periodontics &amp; Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4558-0611","authenticated-orcid":false,"given":"Birtan","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine Infection, and Immunity Division of Periodontology Harvard School of Dental Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara Steiner","family":"Back","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine Infection, and Immunity Division of Periodontology Harvard School of Dental Medicine  Boston Massachusetts USA"},{"name":"Department of Dentistry Center for Education and Research on Dental Implants (CEPID) Federal University of Santa Catarina (UFSC)  Florianopolis Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2628-3525","authenticated-orcid":false,"given":"Fran\u00e7ois","family":"Vigouroux","sequence":"additional","affiliation":[{"name":"Private Practice  Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po\u2010Jan","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Periodontology School of Dentistry Tri\u2010Service General Hospital and National Defense Medical Center  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Tseng","sequence":"additional","affiliation":[{"name":"College of Oral Medicine Chung Shan Medical University  Taichung City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5347-6577","authenticated-orcid":false,"given":"Shayan","family":"Barootchi","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine Infection, and Immunity Division of Periodontology Harvard School of Dental Medicine  Boston Massachusetts USA"},{"name":"Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION) Boston Massachusetts USA"},{"name":"Department of Periodontics &amp; Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12303"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13383"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13417"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2009.090122"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.16-0671"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12226"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016357.2020.1758773"},{"key":"e_1_2_12_9_1","volume-title":"Tunneling. 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