Minimally Invasive Management of Gingival Recession Using Pouch and Tunnel Technique with T-PRF: A Case Report

Abstract

Gingival recession is a mucogingival deformity characterised by apical migration of the gingival margin, which may result in root exposure, dentinal hypersensitivity and aesthetic concern. Minimally invasive periodontal plastic surgical approaches aim to obtain root coverage while preserving soft-tissue integrity and vascular supply. This case report describes the management of Cairo RT1 gingival recession in the maxillary anterior region of a 32-year-old systemically healthy male patient using the pouch and tunnel technique with titanium-prepared platelet-rich fibrin (T-PRF). Clinical examination revealed recession involving teeth 11, 12 and 13, with no interproximal attachment loss, a thin gingival phenotype and satisfactory plaque control. After initial periodontal therapy and reinforcement of oral hygiene instructions, intrasulcular incisions were made without vertical releasing incisions. A full-thickness mucoperiosteal tunnel was created beyond the mucogingival junction while preserving the interdental papillae. The exposed root surfaces were debrided and planed, and a T-PRF membrane prepared from the patient’s blood was positioned within the tunnel over the recession defects. The gingival margin was coronally advanced and stabilised using sling sutures. Postoperative care included analgesics, chlorhexidine mouth rinse, avoidance of mechanical disturbance and dietary instructions. Healing was uneventful after suture removal, and the treated area showed satisfactory root coverage and improved aesthetic appearance. This case suggests that the combined approach may be suitable for selected Cairo RT1 recession defects, although further controlled studies are required.