Root coverage with apical tunnel approach using propolis as a root conditioning agent: A case report with 2-year follow-up and review of the literature

Clin Exp Dent Res. 2023 Aug;9(4):568-573. doi: 10.1002/cre2.751. Epub 2023 Jun 20.

Abstract

Objectives: One of the main challenges in performing root coverage is patient discomfort and donor site morbidity. This case report presents a minimally invasive apical tunnel surgical technique, with propolis for root conditioning, to correct gingival recession defects without harvesting donor grafts, flap elevation, or sutures. Propolis is a natural anti-infective, anti-inflammatory, and antioxidant agent.

Material and methods: A 58-year-old woman with no significant medical history was presented for root coverage of her upper left canine and first premolar with recession type (RT)1A (+). Propolis was used as a root conditioning agent to promote soft tissue coverage via an apical tunnel approach. During the apical tunnel approach, a small apical hole was made 6 mm below the mucogingival junction, and the mucosa and associated attached gingiva was away from the tooth so the flap could be repositioned coronally. Collagen matrix was used as a soft tissue graft material.

Results: At the 2-month, 6-month, 8-month, and 2-year follow-up, complete root coverage was achieved for both teeth. No bleeding on probing was noticed nor recurrent GRs at the treated sites.

Conclusion: Without incisions, donor site reflection, or flaps, the apical tunnel approach can be successfully used to cover the exposed roots. Additionally, propolis is a potential root conditioning agent during soft tissue graft procedure due to its anti-inflammatory and antioxidant properties.

Keywords: apical tunnel approach; gingival recession; propolis; root coverage.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Antioxidants
  • Female
  • Follow-Up Studies
  • Gingival Recession* / surgery
  • Humans
  • Propolis*
  • Tooth Root / surgery
  • Treatment Outcome

Substances

  • Propolis
  • Antioxidants