Evaluation of the Treatment of Multiple Gingival Recession Using Modified Coronally Advanced Tunnel With Subepithelial Connective Tissue Graft Depending on the Positioning of the Graft
- Conditions
- Gingival Recession
- Interventions
- Device: The tunnel technique for root coverage with CTG with outer side of the graftDevice: The tunnel technique for root coverage with CTG with inner side of the graft
- Registration Number
- NCT06366022
- Lead Sponsor
- Medical University of Warsaw
- Brief Summary
Microsurgical coronally advanced tunnel procedures using subepithelial connective tissue grafts (sCTG) are predictable for healing of multiple adjacent type 1 and 2 gingival recessions (RT1 and RT2). In order to reduce patient morbidity and enhance periodontal wound healing with sCTG can be used. The aim of this study is to compare the results of the modified tunneling technique with subepithelial connective tissue graft in gingival recessions placed with the inner side towards the flap cover graft and the outer side towards the flap cover graft.
- Detailed Description
Condition or disease:Multiple Gingival Recession
Intervention/treatment:
Device: Modified coronally advanced tunnel with connective tissue graft placed with inner side towards the flap Device: Modified coronally advanced tunnel with subepithelial connective tissue graft with the outer side towards the flap Phase :Not Applicable
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 20
- Age ≥ 18 years
- Bilateral multiple gingival recessions in homologous teeth in the same arch.
- Full-mouth plaque index ≥ 20% (Ainamo & Bay 1975)
- Full-mouth sulcus bleeding index ≥ 15% (Mühlemann & Son 1971)
- Smoking
- Systemic diseases with compromised healing potential of infectious diseases
- Drugs affecting periodontal health / healing
- Pregnant and lactating females
- Previous periodontal surgery in the area
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Multiple adjacent recessions coverage with sCTG with outer side of the graft The tunnel technique for root coverage with CTG with outer side of the graft Multiple adjacent recessions coverage with subepithelial connective tissue graft.. A modified microsurgical tunnel technique. Initial sulcular incisions with a microsurgical blade are followed by a full-thickness buccal flap preparations till muco-gingival junction using the tunneling knives. Subsequently, the split-thickness preparation is extended into the mucosal tissue to gain sufficient flap mobility. The papillary regions are detached in their buccal aspects with the periosteum. The graft is inserted the outer side into the tunnel and stabilized with absorbable suspensory sutures. The buccal flap is advanced coronally and stabilized with non-absorbable suspensory sutures. Multiple adjacent recessions coverage with sCTG with inner side of the graft The tunnel technique for root coverage with CTG with inner side of the graft Experimental: Multiple adjacent recessions coverage with subepithelial connective tissue graft.. A modified microsurgical tunnel technique. Initial sulcular incisions with a microsurgical blade are followed by a full-thickness buccal flap preparations till muco-gingival junction using the tunneling knives. Subsequently, the split-thickness preparation is extended into the mucosal tissue to gain sufficient flap mobility. The papillary regions are detached in their buccal aspects with the periosteum. The graft is inserted the inner side into the tunnel and stabilized with absorbable suspensory sutures. The buccal flap is advanced coronally and stabilized with non-absorbable suspensory sutures.
- Primary Outcome Measures
Name Time Method Thickness of keratinized tissue (GT Time Frame: 6 months after surgery Thickness of the gingiva measured 2 mm apical to the gingival margin
Recession width (RW) Time Frame: 6 months after surgery Distance measured horizontally at cementoenamel junction level from one border of the recession to another
Clinical attachment level (CAL) Time Frame: 6 months after surgery Distance from the cementoenamel junction to the bottom of the gingival sulcus
Recession height (RH) Time Frame: 6 months after surgery Distance from the cementoenamel junction to the gingival margin
Average recession coverage (ARC) Time Frame: 6 months after surgery The percentage of covered recession area
Width of keratinized tissue (KTW) Time Frame: 6 months after surgery Distance between the most apical point of the gingival margin and the mucogingival junction
Complete recession coverage Time Frame: 6 months after surgery The percentage of sites with complete root coverage
- Secondary Outcome Measures
Name Time Method Root coverage esthetic score (RES) Time Frame: 6 months after surgery A score including root coverage, marginal gingival tissue contour, mucogingival junction alignment, soft tissue texture and gingival colour according to Cairo et al. (1999)
Probing pocket depth (PPD) Time Frame: 6 months after surgery Distance from the gingival margin to the bottom of the gingival sulcus
Patient's satisfaction with treatment Time Frame: 6 months after surgery ] Questionnaire about patient's esthetic perception of gingiva and overall satisfaction using a Visual Analog Scale from 0 (dissatisfaction with esthetic outcome), 2, 3, 4, 5 (moderate satisfaction with easthetic outcome), 6, 7, 8, 9, 10 (best satisfaction with esthetic outcome). Higher values are considered better.
Post surgical pain and swelling Time Frame:, 7 and 14 days after surgery Questionnaire about post surgical pain and swelling using a Visual Analog Scale with values 0 (no pain / swelling), 1, 2, 3, 4, 5(moderate pain/swelling), 6, 7, 8, 9, 10 (worst pain / swelling). Lower values represent lower post surgical discomfort and are considered better.
Trial Locations
- Locations (1)
Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw
🇵🇱Warsaw, MAzowsze, Poland