{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:39:51Z","timestamp":1767191991208,"version":"build-2065373602"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2008,4,1]],"date-time":"2008-04-01T00:00:00Z","timestamp":1207008000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2008,4]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> This article reports a clinical case with a 3\u2010year follow\u2010up in which a subepithelial connective tissue graft (SCTG) was used with the tunnel technique to treat multiple gingival recessions, and describes a technique used to enlarge the extension of the graft.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> A 41\u2010year\u2010old female patient was referred for evaluation and treatment of maxillary multiple recessions. Following basic therapy, the plaque index was 23%, and the gingival index was 12%. Thus, SCTG with the tunnel technique was proposed to provide root coverage of Miller Class I recession on teeth #8 through #11 and a Miller Class III recession on tooth #12. After the donor area had been prepared, SCTG was removed and split cross\u2010sectionally to lengthen it. The graft was placed through the tunnel and sutured.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Two weeks after the surgical procedure, the tissue color was nearly homogeneous with some reddish regions where the connective tissue was left uncovered, and there were no signs of incisions or suture marks. After 3 years of follow\u2010up, the mean coverage of the recessions was 2.2 \u00b1 0.7 mm (74.2%), which corresponded to the gain of keratinized tissue. In addition, a gain in tissue thickness was observed.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> In a long\u2010term evaluation, the tunnel technique with the elongated SCTG was used successfully for treatment of multiple gingival recessions with an increase of the soft tissue volume and gain of keratinized tissue.<\/jats:p>","DOI":"10.1902\/jop.2008.070274","type":"journal-article","created":{"date-parts":[[2008,4,1]],"date-time":"2008-04-01T08:57:21Z","timestamp":1207040241000},"page":"753-758","source":"Crossref","is-referenced-by-count":15,"title":["Tunnel Technique With a Surgical Maneuver to Increase the Graft Extension: Case Report With a 3\u2010Year Follow\u2010Up"],"prefix":"10.1002","volume":"79","author":[{"given":"Fernando S.","family":"Ribeiro","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela L.","family":"Zandim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Em\u00edlia F.","family":"Pontes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael V.","family":"Mantovani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Eduardo C.","family":"Sampaio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Elcio","family":"Marcantonio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,4]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"American Academy of Periodontology.Glossary of Periodontal Terms 4th ed.Chicago:American Academy of Periodontology;2001:44."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1992.63.6.489"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1994.tb00278.x"},{"issue":"1","key":"e_1_2_6_5_1","first-page":"52","article-title":"Gingival lesions caused by improper oral hygiene measures","volume":"7","author":"Agudio G","year":"1987","journal-title":"Int J Periodontics Restorative Dent"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1993.64.9.900"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1967.38.4.316"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1984.tb00911.x"},{"key":"e_1_2_6_9_1","first-page":"209","article-title":"An analysis of localized gingival recession in 766 Winnipeg High School students","volume":"16","author":"Trott JR","year":"1966","journal-title":"Dent Pract Dent Rec"},{"key":"e_1_2_6_10_1","first-page":"9","article-title":"Dimensional alteration of the periodontal tissues following therapy","volume":"7","author":"Lindhe J","year":"1987","journal-title":"Int J Periodontics Restorative Dent"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2842.1982.tb01032.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1978.49.2.67"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1981.52.6.307"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0757.2001.027001097.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1992.63.5.477"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1980.51.3.167"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2004.75.12.1734"},{"key":"e_1_2_6_18_1","first-page":"152","article-title":"Free autogenous gingival grafts. 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