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Comparative Evaluation of Connective Tissue Graft with Pouch/Tunnel Technique versus Connective Tissue Graft with Coronally Advanced Tunnel Flap for the Treatment of Maxillary Recession Cases in Severe Periodontitis



The long-term stability for both the patient and periodontist remains an important priority after connective tissue graft to manage the gingival recession cases. The goal of this analysis was to assess and compare the connective tissue graft with Pouch/Tunnel technique versus connective tissue graft with coronally advanced tunnel flap for the treatment of maxillary recession cases in severe periodontitis.


The total sample size was comprised of 200 subjects. The control group, coronally advanced flap along with connective tissue graft (CTG) was comprised of 100 samples and test group, pouch/tunnel technique with connective tissue graft (POT + CTG) was also comprised of 100 samples. The clinical findings included medium root coverage (MRC) and absolute root (CRC) coverage, gingival (GT) distribution and keratinized tissue (KT) gain. Esthetic findings were also evaluated. All findings analyzed initially after 6th months and have been expanded to 4 years.


There were no major variations between the MRC and CRC patient classes with non significant values. In the POT + CTG category, GT and KT improvements were slightly greater at 4 years, with a substantial improvement in texture in control group.


Pouch/Tunnel technique along with connective tissue graft allows for the clinical coverage of gingival recessions that is equivalent to Coronally advanced flap with CTG, however this may improves the gingival thickness, KT and esthetic performance.

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Correspondence to Xiuneng Zhou.

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Tian, W., Hu, F. & Zhou, X. Comparative Evaluation of Connective Tissue Graft with Pouch/Tunnel Technique versus Connective Tissue Graft with Coronally Advanced Tunnel Flap for the Treatment of Maxillary Recession Cases in Severe Periodontitis. Tissue Eng Regen Med (2021).

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  • Gingival recession
  • Specialized coronary flap
  • Tunnel flap
  • Connective tissue transplant