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Video Details
The "Modified Tunnel" Technique and the development of the Lateral Tunnel Approach

Description:
The "Modified Tunnel" technique is a method of esthetic connective tissue grafting that protects the interdental papillae. First published in 1999, this lateral tunnel approach uses vertical incisions on both sides of the treatment area. These vertical incisions facilitate placement and positioning of the graft over the root surfaces without the need to disturb the interdental papillae. This technique is very useful in esthetic areas and those that involve several teeth. An acellular dermal connective tissue allograft is an excellent choice of graft material to use with this technique.

Date Added:
12/10/2013

Author(s):

Douglas H. Mahn, DDS Douglas H. Mahn, DDS
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Online Videos / Surgery / Soft Tissue / The "Modified Tunnel" Technique and the development of the Lateral Tunnel Approach




Questions & Comments
Maurice Salama - (10/28/2014 8:11 AM)

Helena; Yes, this procedure can be utilized for a single tooth site and Edison, I personally always add PRF to these augmentation procedures although it is NOT a requirement. regards Dr. Salama

Helena DeLuca - (10/27/2014 1:58 PM)

Thank you for your video. Can this procedure be used for a single area on tooth #8 where the lateral access incisions are M and D to a single tooth? Thank you

Edison Louie - (2/15/2014 3:04 PM)

Thank you, Dr. Mahn, for your modified tunneling technique. Would PRF be any benefit to enhancing the healing?

Carl Choi - (2/13/2014 6:53 PM)

Thank you Dr. Mahn. Is your technique perfomed in the supra or subperiosteal plane? If subperiosteal, like the vista tecnique, why not do it supraperiosteally to get more flap release? Thank you.

douglas mahn - (1/9/2014 2:36 PM)

Basement membrane side towards periosteum. Connective tissue side towards overlying gingival flap.

Glen Goldstein - (12/29/2013 9:12 PM)

What is the orientation of the Alloderm? Pink side up?

douglas mahn - (12/18/2013 1:22 PM)

Thank you for viewing this presentation. When creating the gingival tunnel, you can get some coronal movement of the papillae, but you want to be careful not to tear the papillae. I typically use a continuous sling suture. I secure it distal to the treatment area, then weave it forward. I first secure the alloderm in position. Then I move distally securing the gingival flap completely over tha alloderm. I then tie the second knot over the first.

Mindy Gil - (12/18/2013 7:23 AM)

Dear Dr. Mahn, thank you for your lecture. This is very informative. Two questions for you -- 1) do you lift up the papillae between these teeth completely as if you were "tunneling" traditionally? 2) how do you secure the alloderm --- sling sutures? many thanks!

Maurice Salama - (12/17/2013 10:14 AM)

Doug. Well done my friend. Welcome to XP and hope to see ore of your work here soon. Is there still a role for sulcular tunneling in your clinical choices? Thanks Maurice

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