Root coverage of type 2/3 gingival recession using recombinant human fibroblast growth factor‐2 in combination with carbonate apatite granules: A case study
Year: 2026
Type: article
Study design: Case Report
Abstract: Background One of the most challenging aspects of the treatment of Cairo Recession Type (RT) 2/3 gingival recession is the loss of adjacent interdental tissue. Successful treatment can be achieved by repositioning the interdental tissue and applying a connective tissue graft (CTG). Methods and Results Two patients with RT2/3 gingival recession were treated using the vertical incision tunnel (VIT) technique. Recombinant human fibroblast growth factor‐2 (rhFGF‐2)‐soaked carbonate apatite (CO 3 Ap) was placed in the interdental space, while rhFGF‐2‐soaked CTG was used to cover the exposed root surfaces. Over a follow‐up period of up to 2 years, complete or significant root coverage was achieved in both cases. Interdental papillae were successfully reconstructed; however, complete papillary filling was not achieved. Conclusions The combination of rhFGF‐2‐soaked CO 3 Ap in the interdental space and rhFGF‐2‐soaked CTG for root coverage represents an effective approach for treating RT3 gingival recessions. Key points This case presents a novel technique combining recombinant human fibroblast growth factor‐2 (rhFGF‐2)‐soaked carbonate apatite (CO 3 Ap) granules with a connective tissue graft (CTG) for root coverage and interdental papilla reconstruction in Recession Type (RT) 2/3 recession cases. Successful outcomes were attributed to the use of a vertical incision tunnel (VIT) approach, which preserved the blood supply to the papilla, and the synergistic regenerative effects of rhFGF‐2, CO 3 Ap, and CTG. Despite significant improvements, complete papilla fill was not achieved in all cases, and the biological activity of rhFGF‐2 occasionally led to excessive tissue proliferation requiring additional procedures. Further studies with larger sample sizes are needed to confirm long‐term stability. Plain language summary Gum recession is a common dental condition where the gums pull away from the teeth, leaving the roots exposed. This can lead to tooth sensitivity, increased risk of decay, and esthetic concerns. Treating advanced forms—classified as Type 2 and Type 3—is especially difficult because not only are the roots exposed, but the gum tissue between the teeth is also lost. In this case report, two patients with these advanced types of gum recession were treated using a novel approach that combines regenerative materials with a minimally invasive surgical technique. A tissue‐regenerating protein called rhFGF‐2 was applied to both a synthetic bone substitute (CO 3 Ap) placed between the teeth and to soft tissue taken from the roof of the mouth. This tissue was used to cover the exposed roots. Over the course of follow‐up, the treated areas healed well: most of the roots became re‐covered with healthy gum tissue, and the tissue between the teeth, although not fully restored, showed clear signs of regeneration. While further studies are needed, this technique may provide a promising new option for patients with difficult‐to‐treat gum recession, especially in cases where traditional treatments have limited success due to loss of supporting structures.
DOI: 10.1002/cap.70031
Authors: Akiyoshi Funato, Akihiko Katayama, Chihiro Ishikura, Yusuke Katsuda, Akira Hasuike
Institution: Nihon University
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7127130603