Background: Gingival recession following orthodontic tooth movement is a recognized complication, particularly when teeth are repositioned beyond the boundaries of the alveolar bone envelope. The tunneling technique for subepithelial connective tissue grafting has gained popularity owing to its minimally invasive approach, superior esthetic outcomes, and favorable healing profile.
Case Summary: A 23-year-old female patient presented with severe labial gingival recession at the maxillary right canine (tooth 13) following orthodontic treatment involving positional transposition of teeth 13 and 14. Preoperative assessment confirmed Miller Class II recession with a thin periodontal biotype and minimal keratinized tissue width.
Intervention and Outcomes: A subepithelial connective tissue graft harvested from the palate was delivered and stabilized using the tunnel technique. Early wound healing was uneventful and clinically promising. At 9-month follow-up, complete root coverage was achieved at tooth 13, with a probing depth of 2 mm, significant gain in keratinized tissue width, and no evidence of recession recurrence.
Conclusions: The tunneling technique provides a reliable and esthetically acceptable solution for post-orthodontic recession management. Careful case selection, atraumatic tissue handling, and appropriate patient follow-up are critical determinants of treatment success.