Vertical coronally advanced flap with periosteal pedicle graft for gingival recession coverage in mandibular anterior region

Sharmistha Majumder, Akanksha Singh, Rika Singh, Mansi Varshney*, Bhavya Agarwal

Department of Periodontology and Implantology, Institute of Dental Sciences, Bareilly International University, Bareilly, Uttar Pradesh, India

Refer this article

Sharmistha Majumder, Akanksha Singh, Rika Singh, Mansi Varshney, Bhavya Agarwal, 2026. Vertical coronally advanced flap with periosteal pedicle graft for gingival recession coverage in mandibular anterior region. Journal of medical pharmaceutical and allied sciences, V 15, I 3, Pages 37 – 41. Doi: https://doi.org/10.55522/jmpas.V15I3.7021.

ABSTRACT

Mandibular anterior gingival recession is a problem in dentistry due to poor soft tissue characteristics like the presence of thin soft tissue, shallowness of vestibule, and muscle pull. Though several root coverage techniques are available, achieving predictable and stable results in such areas may not always be possible. The periosteal pedicle graft is a type of autogenous vascular graft which provides better blood supply without compromising on having a second surgical donor site. This paper aims to outline the use of vertical coronally advanced flap along with a periosteal pedicle graft to treat mandibular anterior gingival recession. A 50-year-old healthy individual presented with symptoms of root exposure and dentinal hypersensitivity in the mandibular anterior region. After clinical examination, a localised Miller Class II gingival recession of about 4 mm associated with teeth 31 and 41 was diagnosed. Radiographic examination revealed adequate interdental bone support but no signs of bone loss due to periodontal disease. Under local anaesthesia, root debridement was done. A vertical coronally advanced flap was prepared at the gingival recession area. Periosteal pedicle grafting was then done with care to preserve the apical blood supply to the graft. The harvested graft was then placed onto the root surfaces and stabilised. Next, the flap was coronally advanced to cover the entire graft and sutured to get a tension-free adaptation. One month postoperatively, there was an improvement in the healing status of the soft tissues, a reduction in the depth of gingival recession, an increase in gingival thickness, and the absence of dentinal sensitivity. It is found that the application of periosteal pedicle graft in conjunction with vertical coronally advanced flap gives good results. Better root coverage and thickened gingiva are seen as a result of this procedure. However, further research is necessary to establish the validity of the results.

Keywords:

Gingival recession, Coronally advanced flap, Periosteal pedicle graft, Root coverage, Periodontal plastic surgery.

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