8198 Indian Journal of Forensic Medicine & Toxicology, October-December 2020, Vol. 14, No. 4 Modifed Semilunar Advanced Flap with Connective Tissue Graft Technique for Root Coverage: A Case Report Anurag Satpathy 1 , Bhagyashree Lenka 2 , Rinkee Mohanty 3 1 Professor, 2 Post Graduate Student, 3 Professor and Head, Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha Abstract Gingival recession may not only result in aesthetically unacceptable results but also be associated with increased susceptibility to root caries and dentinal hypersensitivity. A novel technique for recession coverage by using a modifed semilunar advanced fap technique with connective tissue graft is described. The technique involves placing of connective tissue graft underneath a semilunar incision which is made parallel to the free gingival margin of the facial tissue and its advancement over the denuded root. This technique has the advantage over conventional semilunar fap, in that beneft of connective tissue graft is combined for improved prognosis Keywords: Semilunar fap, connective tissue graft, gingival recession, coronally advanced fap. Corresponding Author: Prof. Anurag Satpathy Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha e-mail: drasatpathy@gmail.com Introduction Gingival recession (GR) is a common concern of many patients who visit a dental ofce, but despite the concern of patients, the practice of recession coverage often eludes general dentists owing to the need for superior skills. In gingival recession there is an apical shift of the marginal gingiva resulting in denuded root surfaces 1 . It not only is an esthetic concern but also causes dentinal hypersensitivity. Tissue destruction that takes place in periodontal disease or mechanical factors due to toothbrushing can cause GR 2,3 . Root coverage (RC) is indicated when there is an esthetic concern, dentinal hypersensitivity, root caries, cervical abrasion and prevention of periodontal disease progression 4-6 . Several surgical approaches have been put forth in the management of denuded root surfaces. Among these, the subepithelial connective tissue graft (SCTG) procedure, has been considered as the most efcacious and with most predictable outcomes 7,8 . Introduced for RC in 1985, SCTG has been performed by using a variety of fap designs 9,10 . In the following year, ie in 1986, Tarnow et al 11 introduced the semilunar coronally advanced fap (SCAF) procedure. Case reports with connective tissue graft for treatment of isolated gingival recession have shown a high success rate 12-14 . The present case report utilizes a modifed semilunar advanced fap technique in combination with connective tissue graft in the management of gingival recession. Case Report: A male patient aged 32 years was enrolled in the OPD of the Department of Periodontics, Institute of Dental Sciences, Bhubaneswar, Odisha,with a chief complaint of receding of gums in the upper central incisor (tooth number 11). The patient had no faulty tooth brushing habits or any parafunctional habits and hadn’t taken any antibiotics in the preceding six months. He neither had any prosthesis in the anterior region nor did any tooth receivea restorative therapy. His medical history was non-contributory. Intraoral examination: Class I Miller’s gingival recession was observed in the tooth number 21 (Fig 1). Clinical measurements such as a recession defect of 2mm (Fig 2) and width of keratinized tissue of 4mm