Multiple adjacent gingival recessions : which technique to use , tunnel or flap ?

Aesthetic concerns play a major role in the treatment planning of dental care and in every periodontal practice. Gingival recessions are one of the prevalent problems that require clinicians’ attention because of the patient’s aesthetic demands and the possible health complications, such as dentin hypersensitivity and root caries. The cosmetic expectations of our patients and their dental health are the primary indication for performing periodontal plastic surgery and soft-tissue reconstructive surgery. It is the responsibility of the clinician to understand patient demands for aesthetics, the indications and limitations of surgical treatment, and to acquire the needed surgical skills to perform delicate procedures aimed at achieving optimal aesthetics. These procedures need to ensure the best possible results with minimal discomfort and maximal safety for our patients. Periodontal plastic-surgery procedures are designed to correct defects in the morphology, position, and amount of gingiva. The present debate focuses on the treatment of multiple adjacent gingival recessions with two surgical approaches: the coronally advanced flap (with or without connective tissue graft) and the tunnelling procedure. Each technique has its own advantages and limitations and the two procedures are well documented in the literature. Here, two opinion leaders – Massimo de Sanctis and Ion Zabalegui – share their clinical views and long-term experience to help us decide which approach we should carry out in different clinical situations.