Clinical Outcomes of Modified Coronally Advanced Tunnel Technique With Deepithelialized Connective Tissue Graft for Mandibular Lingual Root Coverage: A Case Series
Trial Snapshot
- Phase
- Not Applicable
- Status
- Enrolling By Invitation
- Sponsor
- University of Pittsburgh
- Enrollment
- 20
- Locations
- 1
Study Overview
Brief Summary
This study will follow adults who have gum recession on the tongue side of the lower teeth. Participants will receive a gum surgery called the Modified Coronally Advanced Tunnel technique with a connective tissue graft taken from the roof of the mouth. The study will include 20 participants and will follow them for up to 24 months after surgery. The main outcome is how much of the exposed root is covered 6 months after surgery. The study will also measure gum thickness, gum width, tooth sensitivity, healing, patient comfort, satisfaction, and three-dimensional soft tissue changes using intraoral scans.
Detailed Description
This is a single-site prospective case series at the University of Pittsburgh School of Dental Medicine. Adults with single or multiple Cairo RT1 lingual gingival recessions of at least 3 mm on mandibular incisors, canines, or premolars will be enrolled if they meet the study eligibility criteria.
All participants will receive the same surgical treatment. During the procedure, the surgeon will create a tunnel under the gum tissue on the tongue side of the affected lower tooth or teeth. A small piece of tissue will be taken from the palate, prepared as a connective tissue graft, placed under the gum tissue, and stabilized with sutures to help cover the exposed root surface.
Participants will have study visits before surgery, on the day of surgery, during early healing, and at scheduled follow-up visits through 24 months after surgery. The primary outcome will be assessed at 6 months after surgery.
At follow-up visits, the study team will collect gum measurements, assess tooth sensitivity, record healing or post-operative complications, and collect patient-reported outcomes about pain, discomfort, function, appearance, and satisfaction. Intraoral photographs and intraoral scans will also be collected to document healing and measure three-dimensional soft tissue changes over time.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Treatment
- Masking
- None
Masking Description
A calibrated examiner, blinded to baseline measurements, will perform all post-operative clinical assessments to minimize measurement bias.
Eligibility Criteria
- Ages
- 18 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age 18-65 years
- •Single or multiple Cairo RT1 lingual gingival recessions ≥3 mm on mandibular incisors, canines, or premolars
- •Identifiable CEJ on the lingual aspect
- •Vital uniradicular teeth
- •Full-mouth plaque score <20%
- •Smokes less than 10 cigarettes per day
- •Adequate mouth opening for lingual access
- •Sufficient palatal donor tissue thickness (≥2 mm at 2-3 mm from gingival margin)
Exclusion Criteria
- •Positive urine pregnancy test or self-reported lactation
- •Smoker more than 10 cigarettes per day
- •Uncontrolled systemic diseases, at the discretion of the PI (diabetes HbA1c >7%, cardiovascular disease, immunocompromised)
- •Use of medications affecting periodontal tissues (phenytoin, calcium channel blockers, immunosuppressants)
- •Use of blood thinners
- •Previous root coverage surgery at treated sites
- •Teeth with cervical restorations or caries on lingual surfaces
- •Inadequate attached gingiva (<1 mm)
- •Prominent lingual frenum attachment requiring frenectomy
Arms & Interventions
Modified Coronally Advanced Tunnel with Connective Tissue Graft
Adults with single or multiple Cairo RT1 mandibular lingual gingival recessions of at least 3 mm on mandibular incisors, canines, or premolars who will receive standardized Modified Coronally Advanced Tunnel surgery with a deepithelialized connective tissue graft and will be followed for up to 24 months.
Intervention: Modified Coronally Advanced Tunnel with Connective Tissue Graft (Procedure)
Investigators
Andrea Ravida
Assistant Professor
University of Pittsburgh