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This case report describes the predictable coverage of multiple adjacent maxillary gingival recessions using the modified coronally advanced flap (MCAF) technique and modified coronally advanced tunnel technique (MCAT) in conjunction with an acellular porcine-derived collagen matrix (mucoderm(r)) combined with enamel matrix derivative (Straumann(r) Emdogain(r)).
The exposed root surfaces were cleaned with curettes, under local anesthesia, in the region #12 to #14, and split thickness oblique papillary incisions were made according to the modified coronally advanced flap (MCAF) technique (Zucchelli & DeSanctis J Periodontol 2000), thereby creating a new "surgical papilla" and a connective tissue bed (Figs.
Recent systematic reviews and consensus reports on root coverage procedures1,2 concluded that the addition of autologous connective tissue graft (CTG) or Emdogain(r) (EMD) under a Coronally Advanced Flap (CAF) are the procedures of choice to achieve complete root coverage as they both have extensive evidence showing that they significantly improve root coverage compared with CAF alone.
A split mouth, randomized clinical trial3, has shown that treatment of gingival recession defects with either CAF+CTG or CAF+ EMD appears stable, clinically effective, and similar to each other on all measured parameters, even after 10 years.
Because the CAF+EMD procedure avoids the need for a CTG harvesting procedure, it is the preferred treatment of most patients.
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