Comparative Evaluation of Laterally Closed Tunnel (LCT) Technique and Modified Coronally Advanced Tunnel (MCAT) Technique in the Treatment of Isolated Gingival Recession: Randomized Controlled Clinical Trial

Local anesthesia using 4% articane with 1:100.000 epinephrine was applied.• Then specially designed tunneling instruments \[devmed\] were used through the sulcular incision to create a pouch. A microsurgical blade was used at the inner surface of the pouch till sufficient tissue release was achieved. Tissue forceps was used to approximate the mesial and distal margin of the gingiva at the pouch margin. After harvesting the graft, it was placed at the prepared pouch after root surface biomodification using EDTA gel 24% for 2 minutes and copious rinsing with saline solution. SCTG was pulled using single or mattress sutures and the graft was fixed mesial and distal at the inner part of the pouch using resorbable suture material \[Vicryl suture\], then the graft was sutured around the neck of the CEJ by sling suture 6/0 polypropylene.

Local anesthesia using 4% articane with 1:100.000 epinephrine was applied.• Then specially designed tunneling instruments \[devmed\] were used through the sulcular incision to create a pouch. A microsurgical blade was used at the inner surface of the pouch till sufficient tissue release was achieved. Tissue forceps was used to approximate the mesial and distal margin of the gingiva at the pouch margin. After harvesting the graft, it was placed at the prepared pouch after root surface biomodification using EDTA gel 24% for 2 minutes and copious rinsing with saline solution. collagen matrix was pulled using single or mattress sutures and the graft was fixed mesial and distal at the inner part of the pouch using resorbable suture material \[Vicryl suture\], then the graft was sutured around the neck of the CEJ by sling suture 6/0 polypropylene.

Supraperiosteal incisions was extended to the mucosal level beyond the MGJ to allow sufficient tissue mobility and release. The tunnel was extended in all directions around the recession defect to create a sufficient pouch for connective tissue graft stabilization. The interdental papilla tunneling adjacent to the defect was a critical step for technique success. Then perfect root planning was performed at the denuded root surface to remove the necrotic cementum at the accessible recession defect. Subsequently palatal anesthesia was given to harvest palatal SCTG using deepitheliailized free gingival graft (FGG) technique. SCTG was pulled using single or mattress sutures and the graft was fixed mesial and distal at the inner part of the pouch using resorbable suture material \[Vicryl suture\], then the graft was sutured around the neck of the CEJ by sling suture 6/0 polypropylene.

Supraperiosteal incisions was extended to the mucosal level beyond the MGJ to allow sufficient tissue mobility and release. The tunnel was extended in all directions around the recession defect to create a sufficient pouch for connective tissue graft stabilization. The interdental papilla tunneling adjacent to the defect was a critical step for technique success. Then perfect root planning was performed at the denuded root surface to remove the necrotic cementum at the accessible recession defect. Subsequently palatal anesthesia was given to harvest palatal SCTG using deepitheliailized free gingival graft (FGG) technique. collagen matrix was pulled using single or mattress sutures and the graft was fixed mesial and distal at the inner part of the pouch using resorbable suture material \[Vicryl suture\], then the graft was sutured around the neck of the CEJ by sling suture 6/0 polypropylene.