Shivaprasad .
1,2 
, Vaishnavi Pandey
1,2* 1 Manipal College of Dental Sciences, Manipal, India
2 Manipal Academy of Higher Education, Manipal, India
Abstract
Gingival recession presents both aesthetic and functional challenges, often requiring surgical correction to achieve root coverage and tissue stability. This case report describes a novel modification of the coronally advanced flap (CAF) technique that combines a single vertical incision with Zucchelli’s envelope design for managing multiple adjacent Miller’s Class I recessions. The approach aims to enhance vascularity, flap mobility, and aesthetic integration while minimizing surgical trauma. With this rationale, the case report describes a 45-year-old male with root exposure and dentin hypersensitivity in teeth #13 to #16 due to traumatic brushing. Clinical examinations revealed Miller’s Class I recession, probing depths≤2 mm, and a thick gingival phenotype. A modified CAF with a split-full-split thickness design and a single vertical incision was performed following de-epithelialization of the interdental papillae. The flap was coronally advanced and secured without tension. Healing was uneventful, with partial (70%) root coverage at 1 month and complete (100%) root coverage achieved by 3 months. This was maintained with an average gain of 2 mm in keratinized tissue and harmonious color blending at the 12-month follow-up. This technique provides a predictable and aesthetically refined solution for multiple adjacent recessions, offering a promising alternative to conventional CAF procedures.