Lateral overlap technique for the treatment of isolated deep Miller Class II/III gingival recession in mandibular anterior teeth: A single-arm interventional study

Abstract

Background: Treating deep isolated mandibular recession defects, especially Miller Class III cases, remains a significant challenge due to factors such as shallow vestibules, muscle pull, reduced keratinized tissue width (KTW), and tooth malposition. Although various techniques have been explored, predictable outcomes with complete root coverage (RC) in such cases are rarely documented in the literature. Materials and Methods: Thirty-two systemically healthy patients (22 males and 12 females) aged 22–36 years, with isolated mandibular recessions measuring 6–11 mm, were treated using the lateral overlap technique (LOT) combined with coronal flap displacement and subepithelial connective tissue grafts. Clinical parameters, including gingival recession depth (GRD), KTW, and probing depth, were evaluated over a 1-year follow-up. Results: Significant improvements were observed: GRD reduced from 5.55 ± 0.89 mm to 0.17 ± 0.16 mm, KTW increased by 3.26 ± 0.37 mm, and the mean percentage of RC was 96.81 ± 2.83. Conclusion: LOT with connective tissue grafting is a reliable and effective approach for managing deep isolated mandibular Miller Class II and III gingival recessions, achieving excellent clinical outcomes. © 2025 Indian Society of Periodontology.