The case shown here is of a 24 year-old female patient periodontally healthy, with high oral hygiene standards and an extra-oral piercing in the lower lip, causing the marginal gingival recessions in the two lower central incisors.

Although she was a smoker of less than 10 c.p.d. she was highly compliant with treatment. Both pre and post-operative instructions given were followed strictly. Root coverage was 100%. Needless to say, the etiological factor – the piercing – was removed on a permanent basis.


The technique used here was the tunnel subepithelial connective tissue graft technique described by Zabalegui and cols. for the coverage of multiple adjacent gingival recessions. This technique presents clear advantages concerning early healing of the soft tissues – both of the donor and receptor areas – as well as highly predictable root coverage results. Colleagues and former students affectionately refer to it as the “Tunnelegui”. Like any other periodontal plastic surgery procedure there is a learning curve to it. Not only do “hands” count but also the instruments used. Minimally invasive is in order for both clinical and patient-related successful outcomes. But like Dr. Ion Zabalegui taught us well, practice does make perfect. Have a look at the results of this awesome technique.

Read the Article here.


  1. Obtain complete root coverage
  2. Increase the amount of keratinized tissue
  3. Improve the long term prognosis of the teeth

Skills Involved

  • Diagnosis of marginal gingival recessions
  • Knowledge of periodontal plastic surgery techniques
  • Management of minimally invasive surgical techniques
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