Clinical and aesthetic outcomes after laterally closed tunnel for isolated mandibular gingival recessions: Case series with 18-month follow-up.

BACKGROUND: Gingival recession, particularly in the anterior mandible, causes aesthetic and sensitivity problems for patients and is typically managed using various grafting techniques. However, data on the long-term outcomes of the laterally closed tunnel (LCT) technique in isolated mandibular recessions remain limited. This case series uniquely presents an 18-month clinical follow-up evaluating soft tissue stability and aesthetic outcomes following the LCT procedure, thereby contributing valuable evidence on this minimally invasive approach. METHODS: Seven healthy patients with isolated mandibular Cairo RT I-III recessions were treated via the LCT technique with subepithelial connective tissue grafts (SCTGs). The clinical parameters evaluated in this study were gingival recession width (GRW) and depth (GRD), gingival thickness (GT), keratinized tissue width (KTW), and the root coverage aesthetics score (RES); data were recorded at baseline and at 1.5 months (T1), 6 months (T2), and 18 months (T3) after surgery. Additionally, the plaque index, gingival index, bleeding on probing, periodontal pocket depth, and clinical attachment level were assessed only at baseline to determine the patients' periodontal health status. Owing to nonnormal data (p < 0.05), the Friedman and Bonferroni-adjusted Wilcoxon tests were used with a significance level of 0.05. RESULTS: Seven patients (mean age: 31.29 ± 8.92 years) were included. Statistically significant improvements were observed in GRD (p = 0.0008) and GT (p = 0.0117), whereas other parameters were not significantly changed after treatment. Most clinical improvements occurred within the early postoperative period and remained stable over time. At 18 months, all patients achieved partial root coverage, with a mean coverage rate of 42.98%. The aesthetic outcomes improved by 6 months and remained stable thereafter, with no significant differences between time points (p = 0.93). CONCLUSIONS: The LCT technique appears to be a clinically effective approach for managing isolated mandibular gingival recessions, demonstrating improvements early after treatment. However, the lack of complete root coverage (RC) highlights the technique's sensitivity and the need for its validation through larger, controlled clinical studies.