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ePaper created 2016-03-07, 22:38:59 | version 1.38.0
Journal of Oral Science & Rehabilitation 58 Volume 2 | Issue 1/2016 the homolateral canine.12 In tunneling cases, the midline papilla was tunneled with a dedicated instrument (stoma periostealelevatorfortunne ling,2mm,StorzamMark,Emmingen-Liptingen, Germany), while in conventional CAF cases, two incisions were carried out on the midline papilla, outliningthesurgicalpapillathatwassubsequent ly elevated. Thereafter, the flap was raised with a sequence of split-thickness dissection of the pa pillae,followedbyafull-thicknesselevationalmost 2 mm apical to the mucogingival junction and by asplit-thicknessdissectioninthesuperficiallayers C o r o n a l l y a d v a n c e d f l a p i n t h e t r e a t m e n t o f b i l a t e r a l m u l t i p l e g i n g i v a l r e c e s s i o n s Figs. 1 & 2 Figs. 3 & 4 Fig. 5 Fig. 1 Test case: Preoperative situation. Fig. 2 Test case: Postoperative situation after CAF performed with a tunneling procedure on the midline papilla. Fig. 3 Test case: Clinical situation at seven days, immediately after suture removal. Fig. 4 Test case: Clinical situation at two months. Fig. 5 Test case: Clinical situation at one year. of the muscles underneath the alveolar mucosa until a passive coronal displacement of the flap was obtained. The residual epithelium covering the papillae in the portion coronal to the oblique incisions outlining the surgical papillae in the flap was then removed by means of a #15C blade. In every case in which during surgery a frenum was considereddetrimentalforthefinalresult,amini mal frenectomy was performed. The flap was then secured in a coronal posi tion, covering the cementoenamel junction of each involvedtooth bysuturingthe papillaewith