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Clinical Evaluation of the Modified Laterally Stretched Technique (RT2) Gingival Recession vs Tunneling With CT Grafting

Phase 2
Not yet recruiting
Conditions
Gingival Recession
Interventions
Procedure: Modified laterally stretched technique with a connective tissue graft.
Registration Number
NCT06044870
Lead Sponsor
Cairo University
Brief Summary

Regression analysis in a recent systematic review showed significantly greater mRC and CRC values when modifications are done to the TUN procedure to achieve more coronal advancement of the flap, coronal advancement also helps in covering the underlying graft for better recession coverage outcomes (Tavelli et al., 2018), limited data is present on the possible influence of a covered or partially uncovered graft. However, it has been suggested that minimal exposure of the CTG may aid not only in achieving CRC but also a harmonious gingival margin (John et al., 2015; Rasperini et al., 2011).

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
26
Inclusion Criteria

Not provided

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Exclusion Criteria
  • Pregnant or lactating females.
  • Tobacco smoking.
  • Uncontrolled medical conditions.
  • Uncooperative patients or unable to complete the study.
  • Patients treated with any medication known to cause gingival hyperplasia.
  • No occlusal interferences.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Modified laterally stretched technique with a connective tissue graft.Modified laterally stretched technique with a connective tissue graft.After the administration of local anesthesia, root planing of the exposed root surfaces will be performed by means of hand instruments. A partial thickness envelope is performed with tunneling instruments involving one or two teeth adjacent to the tooth, in case of a very thin biotype a complete thickness envelope could be done. Two horizontal incisions are done at the base of the papillae, allowing to place the graft in a more coronal position and improving access and visibility.
Tunneling technique with connective tissue graft.Modified laterally stretched technique with a connective tissue graft.Immediately before surgery, contact point composite stops were placed to prevent the collapse of the suspended sutures in the inter-proximal spaces.• The entire gingival papillary complex will be moved coronally using a vertical mattress suture anchored in the lingual gingiva. The anchorage in the lingual gingiva will be placed far apically. The suture must capture the buccal flap and graft to avail optimal stabilization (Aroca et al., 2010, 2013; Azzi et al, 2002).
Primary Outcome Measures
NameTimeMethod
Recession depth reduction.1 year

Measured as the difference between the recession gingival depth at different follow up intervals and the baseline.

Secondary Outcome Measures
NameTimeMethod
Keratinized tissue width1 year

Measured as the distance between the gingival margin and the muco-gingival junction.

Esthetics (RES) score1 year

A system used to evaluate five variables 6 months gingival margin (GM), marginal tissue contour (MTC), soft tissue texture (STT), MGJ alignment, and gingival color (GC).

Mean root coverage1 year

(Preoperative vertical recession - Postoperative vertical recession/preoperative vertical recession) x 100

Recession width1 year

Measured as the distance between the between the mesial gingival margin and distal gingival margin

Recession depth1 year

Measured as the distance between the free gingival margin and the cemento-enamel junction .

Soft tissue thickness1 year

The measurement of Gingival tissue thickness is performed 2 mm apical from the gingival margin.

patient satisfaction1 year

A 3-item questionnaire is asked, and the patients shall use a 7-point answer scale. The answers were given on a 7-point scale ranging from 1 'not at all'' to 7 ''very likely''.

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