A Novel and Minimally Invasive Approach Using the Root and Cervical Margin Flattening Procedure for Treating Gingival Recession: A Report of Four Cases

Traditional plastic surgery techniques for root coverage using connective tissue grafts are often invasive and cause patient discomfort. A new procedure with a minimally invasive approach for gingival recession was developed and termed the "root and cervical margin flattening procedure." A blunt incision was performed in the buccal gingival sulcus at the alveolar bone crest with a dissector or raspatory. After the incision, a split-thickness flap was dissected extending beyond the mucogingival junction, palpating the alveolar bone crest with a periodontal probe and flattening the cervical region and roots to smooth out irregularities along the dental root. In some complicated cases, more reliable effects were expected using a periodontal tissue regeneration drug and protective splint. The creeping attachment distance reached the flattened area. Careful blood clot preservation was crucial in the postoperative period. The gingival creeping attachment implied two main factors. First, surgical invasion could promote healing. Second, soft tissue space was increased due to root flattening. This simple and minimally invasive approach for treating cervical lesions (including non-carious cervical lesions and cervical/root caries) and gingival recession could obviate the need for connective tissue grafts. Further clinical studies are required to assess its success and prognosis.