Category: Pinhole News

Case Identification
Procedure: Pinhole® Surgical Technique
Tooth/Teeth: #21–28, 31
Procedure date: 12/22/25
Post-operative interval: 6 Weeks
Post-operative examination date: 02/01/26
Procedure time: 11:34 AM – 12:18 PM (44 minutes)

This case documents a 6-week clinical observation following treatment of mandibular gingival recession involving teeth #21–28 and #31 using the Pinhole® Surgical Technique.

The pre-surgical photograph demonstrates gingival recession affecting the mandibular anterior and posterior region, with visible root exposure and reduced soft-tissue thickness. The follow-up image was obtained six weeks post-treatment, allowing evaluation beyond immediate post-operative changes and into the early remodeling phase of soft-tissue healing.

At the 6-week post-operative interval, the treated sites demonstrate:

• Improved gingival margin position relative to the pre-surgical presentation
• Early stabilization of soft-tissue adaptation along the cervical tooth contours
• Increased tissue volume and a smoother gingival contour in the treated region
• Tissue appearance consistent with ongoing remodeling and maturation

At this interval, the tissues have progressed through initial healing and are continuing through early remodeling. The clinical appearance may continue to refine over subsequent months as biologic maturation progresses.

The clinical significance of this case lies in the demonstration of early soft-tissue improvement and favorable adaptation in the mandibular arch at a short-term follow-up interval following a minimally invasive periodontal procedure performed without incisions or sutures.

The Pinhole® Surgical Technique, developed by Dr. John Chao, is a biologically driven approach to the management of gingival recession that emphasizes tissue preservation, controlled release, and long-term stability.

For additional information:
www.pinholesurgicaltechnique.com

Case Identification
Procedure: Pinhole® Surgical Technique
Tooth/Teeth: #12–13
Procedure date: 2005
Post-operative interval: 20 Years
Post-operative examination date: 01/30/26

This case documents a 20-year clinical observation following treatment of localized gingival recession at teeth #12 and #13 using the Pinhole® Surgical Technique.

The pre-surgical photograph was obtained in 2005 and demonstrates localized recession with visible root exposure in the maxillary left anterior region. The follow-up image was captured 20 years post-treatment, allowing evaluation of soft-tissue behavior well beyond early healing, maturation, and intermediate remodeling phases.

At the 20-year post-surgical interval, the treated sites demonstrate:

• Stable coronal gingival margin position relative to the cervical tooth contours
• Maintained soft-tissue thickness and tissue adaptation at the treated teeth
• Favorable gingival contour without visible scarring
• No obvious clinical signs of relapse when comparing available landmarks

Despite differences in camera angle, lighting, and retraction between the two time points, the clinical features permit meaningful comparison of gingival margin position and tissue form. The observed soft-tissue architecture appears stable over an extended interval, suggesting durable tissue behavior at the treated sites.

At this interval, healing and remodeling are considered complete. The gingival margin position and tissue thickness observed reflect long-term biologic stability rather than short-term post-procedural changes.

The clinical significance of this case lies in the documentation of long-term soft-tissue stability maintained over 20 years following a minimally invasive periodontal procedure performed without incisions or sutures.

The Pinhole® Surgical Technique, developed by Dr. John Chao, is a biologically driven approach to the management of gingival recession that emphasizes tissue preservation and long-term stability.

For additional information:
www.pinholesurgicaltechnique.com

Case Identification
Procedure: Pinhole® Surgical Technique
Tooth/Teeth: #20–21
Procedure date: 2010
Post-operative interval: 16 Years
Post-operative examination date: 2026

This case documents a 16-year clinical observation following treatment of localized gingival recession at teeth #20 and #21 using the Pinhole® Surgical Technique.

The pre-surgical photograph was obtained in 2010 and demonstrates localized recession with visible root exposure in the mandibular left premolar region. The follow-up image was captured 16 years post-treatment, allowing evaluation of soft-tissue behavior well beyond early healing, maturation, and intermediate remodeling phases.

At the 16-year post-surgical interval, the treated sites demonstrate:

• Stable coronal gingival margin position relative to the cervical tooth contours
• Maintained soft-tissue thickness and tissue adaptation at the treated teeth
• Favorable gingival contour without visible scarring
• No obvious clinical signs of relapse when comparing available landmarks

Despite differences in camera angle, lighting, and retraction between the two time points, the clinical features permit meaningful comparison of gingival margin position and tissue form. The observed soft-tissue architecture appears stable over an extended interval, suggesting durable tissue behavior at the treated sites.

At this interval, healing and remodeling are considered complete. The gingival margin position and tissue thickness observed reflect long-term biologic stability rather than short-term post-procedural changes.

The clinical significance of this case lies in the documentation of long-term soft-tissue stability maintained over 16 years following a minimally invasive periodontal procedure performed without incisions or sutures.

The Pinhole® Surgical Technique, developed by Dr. John Chao, is a biologically driven approach to the management of gingival recession that emphasizes tissue preservation and long-term stability.

For additional information:
www.pinholesurgicaltechnique.com

Case Identification
Procedure: Pinhole® Surgical Technique
Tooth/Teeth: #21–26, 28, 29
Procedure date: 03/28/25
Post-operative interval: 10 Months
Post-operative examination date: 01/28/26

This case documents a 10-month clinical observation following treatment of mandibular gingival recession involving teeth #21–26, 28, and 29 using the Pinhole® Surgical Technique.

The pre-surgical photograph demonstrates gingival recession affecting the mandibular anterior and premolar region, with visible root exposure and reduced soft-tissue thickness. The follow-up image was obtained ten months post-treatment, allowing evaluation beyond early healing and into the intermediate remodeling and maturation phase of soft-tissue healing.

At the 10-month post-operative interval, the treated sites demonstrate:

• Stable coronal gingival margin position
• Increased and maintained soft-tissue thickness
• Favorable gingival contour without visible scarring
• Tissue appearance consistent with ongoing biologic maturation

At this interval, the tissues have progressed beyond early wound healing and are continuing through longer-term remodeling. The observed gingival margin position and tissue architecture reflect biologic stability rather than transient post-surgical changes.

The clinical significance of this case lies in the demonstration of sustained soft-tissue improvement and stability in the mandibular region at an intermediate follow-up interval following a minimally invasive periodontal procedure performed without incisions or sutures.

The Pinhole® Surgical Technique, developed by Dr. John Chao, is a biologically driven approach to the management of gingival recession that emphasizes tissue preservation, controlled release, and long-term stability.

For additional information:
www.pinholesurgicaltechnique.com

Case Identification
Procedure: Pinhole® Surgical Technique
Tooth/Teeth: #3–14, 18–28, 27–31
Procedure date: 01/23
Post-operative interval: 3 Years
Post-operative examination date: 01/26

This case documents a 3-year clinical observation following treatment of generalized gingival recession involving both the maxillary and mandibular arches using the Pinhole® Surgical Technique.

The pre-surgical photograph demonstrates generalized recession with visible root exposure and reduced soft-tissue thickness across multiple anterior and posterior teeth. The follow-up image was obtained three years post-treatment, allowing evaluation beyond early healing and tissue maturation and into the long-term remodeling and stability phase.

At the 3-year post-operative interval, the treated sites demonstrate:

• Stable coronal gingival margin position
• Maintained soft-tissue thickness and coverage
• Favorable gingival contour without visible scarring
• Tissue appearance consistent with long-term biologic stability

At this interval, healing and remodeling are considered complete. The gingival margin position and tissue architecture observed reflect sustained biologic response rather than short-term post-procedural effects. The absence of observable relapse over three years suggests durable soft-tissue behavior following treatment.

The clinical significance of this case lies in the documentation of long-term stability across a broad range of teeth following a minimally invasive periodontal procedure performed without incisions or sutures.

The Pinhole® Surgical Technique, developed by Dr. John Chao, is a biologically driven approach to the management of gingival recession that emphasizes tissue preservation, controlled release, and long-term stability.

For additional information:
www.pinholesurgicaltechnique.com

Case Identification

Procedure: Pinhole® Surgical Technique
Post-operative interval: 18 Months

Clinical case courtesy of:
Dr. Eugene Taek Soo Chang, DDS

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This clinical case was shared by Dr. Eugene Taek Soo Chang, DDS and documents a long-term follow-up following treatment with the Pinhole® Surgical Technique.

The case was originally performed approximately 18 months prior, and the patient returned for a routine recall visit, allowing evaluation well beyond early healing and into the tissue maturation phase.

At the 18-month post-operative interval, the treated sites demonstrate stable soft-tissue conditions with maintained gingival margin position and healthy tissue appearance consistent with ongoing biologic remodeling.

In this case, teeth #29 and #30 were restored with crowns approximately 6 months after the Pinhole® procedure. At the 18-month recall, the soft tissues surrounding the restored teeth remain stable, with favorable contour and thickness.

These findings reflect long-term tissue response rather than short-term post-surgical changes and highlight the importance of biologically driven healing over time.

We sincerely thank Dr. Eugene Taek Soo Chang, DDS for sharing this case and for allowing us to feature it as part of our ongoing clinical case library.

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For additional information: www.pinholesurgicaltechnique.com

Case Identification

Procedure: Pinhole® Surgical Technique
Tooth/Teeth: #5–6
Procedure date: 2001
Post-operative interval: 25 Years
Post-operative examination date: 2026

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This case documents a 25-year clinical observation following treatment of localized gingival recession at teeth #5 and #6 using the Pinhole® Surgical Technique.

The pre-operative photograph was obtained in 2001 using a Polaroid camera, reflecting the clinical documentation methods available at that time. The follow-up image was captured 25 years post-treatment, allowing evaluation of long-term soft-tissue behavior well beyond early healing, maturation, and intermediate remodeling phases.

At the 25-year post-operative interval, the treated sites demonstrate:

• Stable coronal gingival margin position
• Maintained soft-tissue thickness
• Favorable gingival contour without scarring
• No observable evidence of relapse over time

Despite differences in imaging quality between the two time points, the available clinical features permit meaningful comparison of gingival margin position and tissue form. The observed soft-tissue architecture appears stable over decades, suggesting durable tissue behavior at the treated sites.

At this extended interval, healing and remodeling are considered complete. The gingival margin position and tissue thickness observed reflect long-term biologic stability rather than short-term post-procedural changes.

The clinical significance of this case lies in the documentation of long-term soft-tissue stability maintained over 25 years following a minimally invasive periodontal procedure performed without incisions or sutures.

The Pinhole® Surgical Technique, developed by Dr. John Chao, is a biologically driven approach to the management of gingival recession that emphasizes tissue preservation and long-term stability.

For additional information:
www.pinholesurgicaltechnique.com

Case Identification
Procedure: Pinhole® Surgical Technique
Tooth/Teeth: #4–6, 8, 9, 11–14
Procedure date: 03/25
Post-operative interval: 10 Months
Post-operative examination date: 01/27/26

This case documents the 10-month post-operative outcome following treatment of maxillary gingival recession involving teeth #4–6, 8, 9, and 11–14 using the Pinhole® Surgical Technique.

As documented in the original operative record from March 2025, the primary clinical objective was to achieve adequate soft-tissue release and controlled overcorrection to increase tissue thickness and establish a biologic environment supportive of long-term stability. The intraoperative gingival margin position was intentionally not considered the final outcome.

At the 10-month post-operative interval, the treated sites demonstrate:

• Stable coronal gingival margin position
• Maintained soft-tissue thickness and volume
• Favorable tissue contour without scarring
• Tissue adaptation consistent with ongoing biologic remodeling

At this interval, the tissues have progressed beyond early healing and are continuing through maturation and remodeling. The observed gingival margin position reflects the patient’s biologic response over time rather than intraoperative placement. Additional minor settling may still occur as remodeling continues.

The clinical significance of this case lies in the demonstration of sustained tissue stability achieved through adequate release and biologically guided healing, without the use of incisions or sutures.

The Pinhole® Surgical Technique was developed by Dr. John Chao as a minimally invasive, biologically driven approach to the management of gingival recession.

For additional information:
www.pinholesurgicaltechnique.com

Case Identification
Procedure: Pinhole® Surgical Technique
Tooth/Teeth: #5–12
Procedure date: 01/06/26
Post-operative interval: 3 Weeks
Post-operative examination date: 01/27/26
Procedure time: 11:35 AM – 1:00 PM (85 minutes)

This case documents the 3-week post-operative presentation following treatment of maxillary gingival recession involving teeth #5–12 using the Pinhole® Surgical Technique.

As documented in the operative record from January 6, 2026, the primary clinical objective was to achieve adequate soft-tissue release and intentional overcorrection to increase tissue thickness and establish a biologic environment supportive of favorable healing. The intraoperative gingival margin position was intentionally not considered the final outcome.

At the 3-week post-operative interval, the treated sites demonstrate:

• Early coronal gingival positioning
• Increased soft-tissue thickness and volume
• Favorable tissue adaptation without scarring
• Healing patterns consistent with early biologic remodeling

At this stage, tissues are in the active healing phase and have not yet completed maturation or remodeling. The observed gingival margin position reflects the body’s early biologic response rather than a finalized clinical endpoint. Continued remodeling and settling are expected as healing progresses.

The clinical significance of this case lies in the early demonstration of stable tissue response following adequate release and overcorrection, reinforcing the principle that final gingival position is determined by biology during healing rather than intraoperative placement.

The Pinhole® Surgical Technique was developed by Dr. John Chao as a biologically guided, minimally invasive approach to the management of gingival recession.

For additional information:
www.pinholesurgicaltechnique.com

#PinholeSurgicalTechnique #ClinicalObservation #EarlyHealing #GingivalRecession #BiologyDrivenHealing #MinimallyInvasivePeriodontics #DrJohnChao

Case Identification
Procedure: Pinhole® Surgical Technique
Tooth/Teeth: #2–15
Procedure year: 2023
Follow-up interval: 2 Years
Follow-up examination date: 01/23/26

This case documents the 2-year post-operative outcome following treatment of generalized maxillary gingival recession using the Pinhole® Surgical Technique.

As documented in the original operative record from 2023, the primary clinical objective was to achieve adequate soft-tissue release and controlled overcorrection to increase tissue thickness and establish a biologic environment supportive of long-term stability. The gingival margin position at surgery was intentionally not considered the final outcome.

At the 2-year follow-up interval, the treated sites demonstrate:

• Sustained coronal gingival margin position
• Stable soft-tissue thickness with maintained volume
• Preserved papillary architecture without scarring
• Long-term tissue adaptation consistent with biologic remodeling

At this interval, tissues have completed maturation and remodeling. The observed gingival margin position and contour reflect the patient’s biologic response over time rather than intraoperative placement. Stability at 2 years supports the principle that controlled overcorrection and adequate tissue release allow the gingiva to settle into a durable, biologically determined position.

The clinical significance of this case lies in the demonstration of long-term stability achieved without incisions or sutures, reinforcing the biologic basis of the Pinhole® Surgical Technique.

The Pinhole® Surgical Technique was developed by Dr. John Chao as a biologically guided, minimally invasive approach to the management of gingival recession.

For additional information:
www.pinholesurgicaltechnique.com

#PinholeSurgicalTechnique #ClinicalObservation #GingivalRecession #LongTermFollowUp #BiologyDrivenHealing #MinimallyInvasivePeriodontics #DrJohnChao