Raetzke in 1985 described a bilaminar technique for isolated recession defects, creating an envelope or pouch around the recession area to receive connective tissue graft. However, greater predictability of results became achievable only with the introduction of bilaminar connective tissue grafting techniques. Several innovations, modifications, and variations have been developed for surgical root coverage since Grupe and Warren first described the laterally positioned flap.
Furthermore, it must be remembered that exposed roots are prone to abrasion and erosion. Recession defects are treated to resolve a variety of patient-centered concerns including, but not limited to, root sensitivity, increased potential for root caries, difficulty in plaque control, and esthetics. Gingival recession may be caused by periodontal disease, improper oral hygiene, frenal pull, bone dehiscence, improper restorations, tooth malposition, viral infections of the gingiva, and oral habits. Gingival fenestration defects may create problems regarding plaque control, root hypersensitivity, and esthetics.
Gingival fenestrations are of uncertain etiology and have rarely been reported in the dental literature.
