THE FREE ROTATED PAPILLA AUTOGRAFT - A NEW BILAMINAR GRAFTING PROCEDURE FOR THE COVERAGE OF MULTIPLE SHALLOW GINGIVAL RECESSIONS

The aim of this clinical pilot study is to evaluate the possibility an d, from a statistical point of view, the predictability of a new mucog ingival technique. The purpose of this surgical procedure is to cover the exposed buccal root surface with less than 5 mm clinical probing a ttachment loss either in corono-apical or mesio-distal aspects. This s urgical procedure is particularly indicated in either single or multip le gingival recessions with perfectly preserved mesial and distal inte rproximal osseous crests, and with a papillary dimension not inferior to the defect which needs to be treated. A sharp incision is performed at a 90 degrees angle to the vestibule, following the mucogingival li ne. A sharp dissection is accomplished to create a partial thickness e nvelope flap on the underlying alveolar mucosa, The epithelium from th e facial aspect of the papilla is debrided with a full thickness appro ach, the facial papillary tissue is removed from the underlying tissue bed. The papilla is then reversed in such a way that the base of the papilla is at the cemento-enamel junction (CEJ) and the apex is at the base of the gingival recession area. The papilla is then sutured in p lace and completely covered by a coronally displaced partial thickness flap. The results obtained either as root coverage, or as an aestheti c result, may be considered positive. This procedure has the decided a dvantage of a single surgical site, avoiding any palatal patient disco mfort, good color compatibility with adjacent tissue, and healing by p rimary intention.