Treatment of gingival recession defects using non-invasive pinhole technique with propolis application, a case report

Int J Surg Case Rep. 2021 Jun:83:106042. doi: 10.1016/j.ijscr.2021.106042. Epub 2021 May 26.

Abstract

Introduction and importance: Despite the considerable surgical techniques that have been done for the root coverage, surgical difficulties, time, and patients' discomfort are still the main obstacles. However, the morbidity associated with the secondary graft sites has generated interest in new modalities to achieve the esthetic and functional requirements without complications, to reach patient comfort and satisfaction. In our study, we used a recent novel surgical technique which is called the pinhole surgical technique as it is a minimally invasive treatment that reverses gingival recession without using donor graft, flap elevation, or sutures. In this study, we also used propolis for root conditioning as it is a natural anti-infective, anti-inflammatory, and anti-oxidant agent.

Presentation of the case: A 58-year-old systemically healthy female patient was referred to our periodontal clinics for the root coverage of the upper left canine and the first premolar which were diagnosed as Class II and Class I Miller's classification respectively. A pinhole surgical technique was done using propolis for root conditioning. A pinhole was created and the gingiva was pushed downwards until reaching the desired position coronally with the aid of collagen strips. Then, propolis was applied again postoperatively to enhance healing.

Clinical discussion: Pinhole surgical technique can immediately cover exposed roots without incisions, donor site or flap reflection. In addition, the use of propolis in root conditioning showed positive results. This is due to its antioxidant and anti-inflammatory effects.

Conclusion: Pinhole surgical technique using propolis is a promising modality that reaches the periodontist ambition for gingival recession defects.

Keywords: Gingival recession; Pinhole surgical technique; Propolis; Root coverage.