Comparison of Free Gingival Graft and Modified Apical Repositioning Flap Techniques

Not Applicable

Terminated

• Conditions: Periodontal Diseases
• Interventions: Other: Patients selection; Other: Recall visits

• Registration Number: NCT06253910
• Lead Sponsor: Istanbul Medipol University Hospital

Brief Summary

Attached gingiva, a crucial component of the keratinized tissue, plays a vital role in preserving periodontal health. The free gingival graft (FGG) and modified apically repositioned flap (MARF) techniques are frequently used for addressing issues related to insufficient attached gingiva. The aim of this study was to compare the efficiency of the FGG and the MARF increasing the zone of attached gingiva in 2-year posttreatment.

Detailed Description

The study included 15 participants who were both systemically and periodontally healthy, and these participants had a total of 21 teeth (10 for SDG and 11 for MARF). All included teeth had an attached gingiva width ranging from 0.5 mm to 1.5 mm and showed no signs of bone dehiscence. SDG and MARF methods were selected randomly (coin-to-coin). Clinical parameters recorded at baseline, third month, at first and second years were plaque index (PI), pocket probing depth (PPD), keratinized tissue width (KTW), attached gingiva width (AGW), bleeding on probing (BOP), gingival recession (GR) and clinical attachment level (CAL).

Study Timeline

• Study Start: 2019-02-15
• Primary Completion: 2022-11-22
• Study Completion: 2023-12-01
• Status Verified: 2024-02
• Study First Submitted: 2024-02-02
• Study First Submitted QC: 2024-02-02
• Last Update Submitted: 2024-02-10
• Study First Posted: 2024-02-12
• Last Update Posted: 2024-02-13

Recruitment & Eligibility

• Status: TERMINATED
• Sex: Female
• Target Recruitment: 15

Inclusion Criteria

• having ≥15 permanent teeth excluding third molars,
• not using any orthodontic appliance,
• not being pregnant or breastfeeding,
• not having any uncontrolled chronic and/or auto-immune disease,
• not smoking.

Exclusion Criteria

• having chronic and/or auto-immune disease
• smoking.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Patient selection	Patients selection	A total of 15 (female) patients, between 31 and 70 years, who were systemically and periodontally healthy and applied to the periodontology clinic for treatment, were included in our study. Criteria for inclusion in the study are having ≥15 permanent teeth excluding third molars, not using any orthodontic appliance, not being pregnant or breastfeeding, not having any uncontrolled chronic and/or auto-immune disease, and not smoking.
Post-surgical evalution and periodontal measurements	Recall visits	Clinical periodontal parameters (plaque index (PI), pocket probing depth (PPD), bleeding on probing (BOP), gingival recession (GR) and clinical attachment level (CAL)) were recorded and evaluated at baseline, third months, first and second years. Periodontal measurements (keratinized tissue width (KTW), attached gingiva width (AGW)) recorded and evaluated at baseline, third months, first and second years.
MARF and FGG tehcniques	Patients selection	Free gingival graft for the treatment of a total of 21 teeth with gingival recession in the lower jaw incisors area, no bone dehiscence, and the amount of attached gingiva being at least 0.5 mm and at most 1.5 mm and modified apically positioned flap methods were randomly selected (coin toss) and applied by a single investigator (MY). Surgical methods were performed on a minimum of 1 and a maximum of 2 teeth in the treated areas.

Primary Outcome Measures

Name	Time	Method
Attached gingiva width	Baseline, third month, first year and second years.	The width of the attached gingiva was calculated by measuring the distance from the crest of the gingival margin to the mucogingival junction and then subtracting the probing depth of the gingival sulcus from this distance on the particular tooth.
Keratinized tissue width	Baseline, third month, first year and second years.	The width of the keratinized tissue was calculated by measuring the distance from the crest of the gingival margin to the mucogingival junction

Secondary Outcome Measures

Name	Time	Method
Pocket probing depth	Baseline, third month, first year and second years.	Measurement of the depth of a sulcus or periodontal pocket determined by measuring distance from a gingival margin to the base of the sulcus or pocket with a calibrated periodontal probe.

Trial Locations

Locations (1)

Istanbul Medipol University, School of Dentistry; 🇹🇷 Istanbul, Fatih, Turkey