JDSE
Journal of Dental Sciences and Education

The Journal of Dental Sciences and Education deals with General Dentistry, Pediatric Dentistry, Restorative Dentistry, Orthodontics, Oral diagnosis and DentomaxilloFacial Radiology, Endodontics, Prosthetic Dentistry, Periodontology, Oral and Maxillofacial Surgery, Oral Implantology, Dental Education and other dentistry fields and accepts articles on these topics. Journal of Dental Science and Education publishes original research articles, review articles, case reports, editorial commentaries, letters to the editor, educational articles, and conference/meeting announcements.

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Case Report
Root coverage of an isolated gingival recession using the tunnel technique and a de-epithelialized connective tissue graft: an 8-month follow-up case report
Abstract
Gingival recession is a common mucogingival deformity that may lead to esthetic concerns, dentin hypersensitivity, and impaired plaque control. The tunnel technique combined with a connective tissue graft has been widely used for root coverage because of its predictable clinical and esthetic outcomes. This case report describes the management of deep isolated Cairo RT1 gingival recession defects using the tunnel technique in combination with a de-epithelialized connective tissue graft. A 23-year-old healthy female presented with isolated gingival recession affecting teeth #25 and #26, accompanied by esthetic concerns, dentin hypersensitivity, and discomfort during toothbrushing. The recession depths were 6 mm and 8 mm, respectively, with limited keratinized tissue. Following root surface preparation, root coverage was performed using the tunnel technique and a de-epithelialized connective tissue graft harvested from the palate. Healing was uneventful throughout the postoperative period. At the 8-month follow-up, complete root coverage was achieved at tooth #25, while 75% root coverage was obtained at tooth #26. Keratinized tissue width increased at both treated sites, dentin hypersensitivity and toothbrushing discomfort resolved completely, and the patient reported a high level of esthetic satisfaction. This case demonstrates that the tunnel technique combined with a de-epithelialized connective tissue graft can provide predictable root coverage, favorable soft tissue healing, and satisfactory esthetic and functional outcomes in the treatment of deep isolated Cairo RT1 gingival recession defects.

Keywords : Gingival recession, tunnel technique, connective tissue graft, root coverage

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Informed Consent

Written informed consent was obtained from the patient included in this report. Signed consent forms are retained by the authors and are available upon request.

Author Contributions

The author is solely responsible for the entirety of conception, execution, analysis, and writing of the manuscript.

Conflict of Interest

The author declares no conflicts of interest.

Financial Disclosure

This case report did not receive any financial support.


1. Cairo F. Periodontal plastic surgery of gingival recessions at single and multiple teeth. Periodontol 2000. 2017;75(1):296-316. doi:10.1111/prd.12186
2. Tejedo JRI, Jara RAC, Caceres LZ, et al. De-epithelialized free gingival graft versus subepithelial connective tissue graft in the treatment of gingival recession: a systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal. 2025;30(5):e690-e699. doi:10.4317/medoral.27184
3. Toledano-Osorio M, Muñoz-Soto E, Toledano M, et al. Treating gingival recessions using coronally advanced flap or tunnel techniques with autografts or polymeric substitutes: a systematic review and meta-analysis. Polymers (Basel). 2022;14(7):1453. doi:10.3390/polym14071453
4. Tavelli L, Barootchi S, Nguyen TVN, Tattan M, Ravidà A, Wang HL. Efficacy of tunnel technique in the treatment of localized and multiple gingival recessions: a systematic review and meta-analysis. J Periodontol. 2018;89(9):1075-1090. doi:10.1002/JPER.18-0066
5. Chauca-Bajaña L, Pérez-Jardón A, Silva FFVE, et al. Root coverage techniques: coronally advancement flap vs. tunnel technique: a systematic review and meta-analysis. Dent J (Basel). 2024;12(11):341. doi:10.3390/dj12110341
6. Yadav AP, Kulloli A, Shetty S, Ligade SS, Martande SS, Gholkar MJ. Sub-epithelial connective tissue graft for the management of Miller’s class I and class II isolated gingival recession defect: a systematic review of the factors influencing the outcome. J Investig Clin Dent. 2018;9(3):e12325. doi:10.1111/jicd.12325
7. Cairo F, Pagliaro U, Buti J, et al. Root coverage procedures improve patient aesthetics. A systematic review and Bayesian network meta-analysis. J Clin Periodontol. 2016;43(11):965-975. doi:10.1111/jcpe.12603
8. Dodge A, Garcia J, Luepke P, Lai YL, Kassab M, Lin GH. The effect of partially exposed connective tissue graft on root-coverage outcomes: a systematic review and meta-analysis. Eur J Oral Sci. 2018;126(2):84-92. doi:10.1111/eos.12401
9. Mashaly M, Ghallab NA, Elbattawy W, Elarab AE. Soft tissue augmentation using de-epithelialized free gingival graft compared to single-line incision subepithelial connective tissue graft in the management of Miller class I and II gingival recession: a randomized controlled clinical trial. Contemp Clin Dent. 2022;13(3):227-235. doi:10.4103/ccd.ccd_763_20
10. Zucchelli G, Mele M, Stefanini M, et al. Patient morbidity and root coverage outcome after subepithelial connective tissue and de-epithelialized grafts: a comparative randomized-controlled clinical trial. J Clin Periodontol. 2010;37(8):728-738. doi:10.1111/j.1600-051X.2010.01550.x
11. Hazrati P, Baniameri S, Sabri H, Chele D, Stuhr S. Efficacy of laser for de-epithelialization of free gingival graft: a systematic review. Lasers Med Sci. 2025;40(1):304. doi:10.1007/s10103-025-04554-0
12. González-Febles J, Romandini M, Laciar-Oudshoorn F, et al. Tunnel vs. coronally advanced flap in combination with a connective tissue graft for the treatment of multiple gingival recessions: a multi-center randomized clinical trial. Clin Oral Investig. 2023;27(7):3627-3638. doi:10.1007/s00784-023-04975-7
13. Bakhishov H, Isler SC, Bozyel B, Yıldırım B, Tekindal MA, Ozdemir B. De-epithelialized gingival graft versus subepithelial connective tissue graft in the treatment of multiple adjacent gingival recessions using the tunnel technique: 1-year results of a randomized clinical trial. J Clin Periodontol. 2021;48(7):970-983. doi:10.1111/jcpe.13452
14. Zangrando MSR, Eustachio RR, de Rezende MLR, Sant’ana ACP, Damante CA, Greghi SLA. Clinical and patient-centered outcomes using two types of subepithelial connective tissue grafts: a split-mouth randomized clinical trial. J Periodontol. 2021;92(6):814-822. doi:10.1002/JPER.19-0646
15. Górski B, Górska R, Wysokinska-Miszczuk J, Kaczynski T. Tunnel technique with enamel matrix derivative in addition to subepithelial connective tissue graft compared with connective tissue graft alone for the treatment of multiple gingival recessions: a randomized clinical trial. Clin Oral Investig. 2020;24(12):4475-4486. doi:10.1007/s00784-020-03312-6
Article available in :
Volume 4, Issue 4, 2026
Page : 172-176
https://doi.org/10.51271/JDSE-0095
Article Information
Received : 30 Tem 2026
Accepted : 23 Eki 2026
Published : 28 Eki 2026
Corresponding Author :

Ramazan Ağırağaç: Department of Periodontology, Faculty of Dentistry, Dicle University, Diyarbakir, Turkiye

[email protected]
Citation : Ağırağaç R. Root coverage of an isolated gingival recession using the tunnel technique and a de-epithelialized connective tissue graft: an 8-month follow-up case report. J Dent Sci Educ. 2026;4(4):172-176. doi:10.51271/JDSE-0095

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