İzole Dişeti Çekilmesinin Yönetiminde Minimal İnvaziv Yaklaşım: 26 Ay Takipli Bir Vaka Raporu

Abstract

Amaç: Bu vaka raporunun amacı dişeti çekilmesine bağlı gelişen kök yüzey açıklığının, minimal invaziv yaklaşımla bağ doku grefti kullanarak kapatılmasıdır. Olgu: Dişeti çekilmesi, dişeti marjininin apikal yönde yer değiştirmesiyle, kök yüzeyinin açığa çıkmasına neden olur. Bağ doku grefti kullanarak koronale ilerletilmiş flep tekniği dişeti çekilmesinin yönetiminde altın standarttır. Dişeti çekilmesi ve hassasiyet şikâyeti olan hastada 33 nolu diş bölgesinde cairo sınıflamasına göre RT1 çekilme, 3-4 mm keratinize dişeti miktarı ve kole bölgesinde yaklaşık 1mm derinliğinde aşınma tespit edildi. De-epitelize edilerek bağ dokusu elde edildi. Tünel tekniği ile alıcı alan hazırlanarak bağ doku yerleştirildi ve koronale çekilerek süture edildi. 13. günde süturlar alındı ve 1. ayda 33 nolu dişin kök yüzeyinin tamamen kapandığı gözlendi. 26. ayda dişeti çekilmesinin olmadığı gözlemlendi. Sonuç: RT1 dişeti çekilmesinin tedavisinde bağ dokusu grefti kullanılarak uygulanan tünel tekniği kök kapamada yüksek oranlarda başarı sağlayabilen bir tekniktir.

Keywords

• Bağ doku grefti
• Kök kapama
• Minimal invaziv yaklaşım
• Tünel tekniği

MANAGEMENT OF ISOLATED GINGOVAL RECESSION USING A MINIMALLY INVASIVE TECHNIQUE: A 26-MONTH FOLLOW-UP CASE REPORT

Abstract

This case report aims to describe the management of root surface exposure due to gingival recession using a connective tissue graft with a minimally invasive approach. Gingival recession, characterized by the apical displacement of the gingival margin and subsequent exposure of the root surface, remains a prevalent clinical condition in periodontology. The coronally advanced flap combined with a connective tissue graft continues to represent the gold standard for achieving predictable root coverage. This case report presents the management of an isolated RT1 gingival recession defect in the mandibular canine (tooth #33) associated with dentin hypersensitivity. The site exhibited 3–4 mm of keratinized tissue width and a shallow cervical abrasion of approximately 1 mm. A connective tissue graft was obtained through de-epithelialization of a free gingival graft and placed using a minimally invasive tunneling approach, followed by coronal advancement and tension-free suturing. Postoperative healing was uneventful, and complete root coverage was achieved within the first month. At the 26-month follow-up, the treated site demonstrated stable soft tissue integration without any recurrence of recession. Supporting the conclusion that the tunnel technique with connective tissue graft achieved successful root coverage in RT1 gingival recession.

Keywords

• Connective tissue graf
• Minimally invasive approach
• Root coverage
• Tunnel technique

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