Basically two partial thickness flaps were designed, one each on the mesial and distal sides of the gingival defect. Horizontal incision was made on the interdental papilla at the level of the CEJ. Two oblique releasing incisions were made at the proximal line angles of the adjacent teeth and extended beyond the mucogingival junction
Both the mesial and distal portions of the partial thickness flap were elevated . The exposed root surface was thoroughly planed with a curette. Then chemical root conditioning was performed using a cotton pellet soaked in citric acid solution pH-1 that was applied on the tooth surface for three minutes. The mesial or distal flap was de-epithelialized and the flap was rotated to cover citric acid conditioned root surface
The other un-deepithelialized pedicle flap was repositioned to cover the previous flap. The coronal margin of these two pedicle flaps was immobilized to the tooth using a sling suture .
The oblique releasing incisions on either side of the pedicle flaps were sutured onto the adjacent unreflected periosteum. A periodontal dressing was applied to the surgical site to protect the wound from irritation. After surgery, patients were instructed to discontinue tooth brushing at the surgical area for two weeks and to rinse with 0.12% chlorhexidine solution three times daily for 6-8 weeks. Amoxycillin 500 mg three times a day was prescribed for five days after surgery to prevent infection. Patients were recalled once a week for review for the first month.
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