Würflein, ErikErikWürfleinHerrmann, KatharinaKatharinaHerrmannSculean, AntonAntonSculeanVach, KirstinKirstinVachNelson, KatjaKatjaNelsonFretwurst, TobiasTobiasFretwurstIglhaut, GerhardGerhardIglhautKernen, FlorianFlorianKernen2026-03-092026-03-092026https://boris-portal.unibe.ch/handle/20.500.12422/232868Background To report 24-month clinical and 3D outcomes of single and multiple RT1 and RT2 gingival recessions treated with the modified coronally advanced tunnel (MCAT) technique and an L-PRF-functionalized porcine dermal matrix (PDM), as long-term data on PDM in root coverage are scarce. Methods Patients with single or multiple RT1 and RT2 recessions in the maxilla or mandible were treated with MCAT and L-PRF-functionalized PDM. Conventional impressions taken preoperatively and at 24 months were poured as casts, digitized, and aligned as standard tessellation language (STL) files for quantitative analysis. Outcomes were recession depth (RD), mean and complete root coverage (mRC, cRC), mean recession reduction (mRR), and gingival thickness (GT). Mixed linear models accounting for patient-level clustering were used. Results Eighty-three teeth in 20 patients were available for 24-month analysis. Healing was uneventful. Mean baseline RD was 1.31 ± 0.86 mm. At 24 months, mRC was 80.17 ± 56.68%, cRC 34.78%, and mRR 1.01 ± 0.84 mm. Mean GT gain was 0.22 ± 0.40 mm. Root coverage and GT changes were similar for RT1 and RT2 defects and were not influenced by tooth type or jaw. Conclusions Within the limitations of this prospective single-arm clinical trial, MCAT with a leukocyte- and platelet-rich fibrin (L-PRF) -functionalized PDM provided stable 24-month root coverage and modest GT gain in RT1 and RT2 gingival recessions. These descriptive findings support the clinical applicability of this CTG-sparing approach and underline the need for randomized controlled trials with patient-reported outcomes to compare it with connective tissue grafting. Plain Language Summary Gum recession, where the gum pulls away and exposes the tooth root, can cause sensitivity, esthetic concerns, and tissue loss. In this study we treated 83 teeth in 20 adults with gum recession using a minimally invasive tunnel technique combined with a soft tissue replacement material made from porcine (pig) skin that was coated with a blood concentrate prepared from the patient. We followed the teeth for 2 years and used 3-dimensional (3D) digital models made from dental casts to measure changes in gum position and thickness. On average, exposed root surfaces were reduced by about 80%, and in roughly one third of teeth the roots were fully covered again. The gums also became slightly thicker. Healing was uncomplicated, and results were similar in different tooth types and positions. Because this approach does not require taking a small piece of tissue from the roof of the mouth (connective tissue graft), it may reduce surgical discomfort while still providing stable coverage of exposed roots. However, direct comparisons with the current gold standard, connective tissue grafting, in randomized controlled trials are still needed to confirm these findings and to better understand patient-reported benefits such as pain and satisfaction.enL‐PRFcoronally advanced tunnel techniquegingival recessionmean recession reductionporcine dermal matrixrecession typeroot coverage600 - Technology::610 - Medicine & healtharticle10.48620/960094174404310.1002/jper.70093