Comparing CAF and TCAF With Soft Tissue Grafting for Treating Multiple Recessions in the Premandibula.

Not Applicable

Not yet recruiting

• Conditions: Gingival Recession, Localized; Gingival Recession, Plastic Surgery; Gingival Recessions; Gingival Recession, Mucogingival Surgery

• Registration Number: NCT06940050
• Lead Sponsor: University Hospital, Ghent

Brief Summary

Multiple techniques can be used for recession coverage. The most common techniques are : tunnel technique (T), coronally advanced flap (CAF) or a combination of both (TCAF). Tunnel and coronally advanced flap are frequently used in clinical practice, whereas the combined technique is a rather recent developed surgical approach.

This randomized controlled trial compares CAF and TCAF to determine which technique provides better root coverage for receding gums in the lower front teeth. The main question it aims to answer is:

- What is the average root coverage achieved with each technique in the short and long term?

This may be clinically relevant because covering gum recession can reduce tooth sensitivity, improve aesthetics and make oral hygiene easier.

Researchers will compare the coronally advanced flap (CAF = the gum is detached and repositioned higher) with the tunneled coronally advanced flap (TCAF = the gum is undermined, only partially detached and repositioned higher). In both techniques, a small piece of tissue is removed from the palate, which is used to cover the recession. The purpose of the connective tissue graft under the flap/tunnel is to increase thickness and provide support.

Participants will:

* Undergo surgery (CAF or TCAF, randomly assigned) to cover recessions

* Attend regular check-ups for up to 10 years after surgery

* Keep a postoperative journal (recording medication use, pain levels, tooth sensitivity, etc.)

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2025-03-24
• Status Verified: 2025-04
• Study Start: 2025-04
• Study First Submitted QC: 2025-04-18
• Last Update Submitted: 2025-04-18
• Study First Posted: 2025-04-23
• Last Update Posted: 2025-04-23
• Primary Completion: 2036-12-31
• Study Completion: 2037-12-31

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 34

Inclusion Criteria

• at least 18 years old
• good oral hygiene
• presence of at least 2 recessions in the premandible
• good general health

Exclusion Criteria

• smoker
• pregnant women (assessed at each visit; if the patient appears pregnant during follow-up, x-rays will not be taken)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
mean root coverage	From enrollment till ten years after surgical treatment.	The average percentage of previously exposed tooth root surface that becomes covered by gingival tissue following a root coverage procedure.

Secondary Outcome Measures

Name	Time	Method
treatment time	Only measured during surgery in minutes.	Time in minutes from the first incision till the last suture.
number of analgesics	From one week post-operative till two weeks post-operative.	The number of pain medication tablets consumed by the patient to manage post-operative pain.
score of aesthetic result	From six months post-operative till ten years post-operative.	Aesthetic satisfaction based on root coverage and color match.
complete root coverage	From enrollment till ten years after surgical treatment.	The percentage of teeth for which the previously exposed root surface is completely covered by gingival tissue following the surgical procedure. These teeth show no visible recession after healing.
pocket depth	From enrollment till ten years after surgical treatment.	The distance from the gingival margin to the bottom of the sulcus measured using a periodontal probe.
recession reduction	From enrollment till ten years after surgical treatment.	The decrease in the amount of exposed root surface after the root coverage procedure.
width of keratinized tissue	From enrollment till ten years after surgical treatment.	The distance from the mucogingival junction to the free gingival margin. It includes free and attached gingival tissue, measured with a periodontal probe.
gingival thickness	From enrollment till ten years after surgical treatment.	Thickness of the gingival tissue measured 1-2 mm apical to the gingival margin.
phenotype	From enrollment till ten years after surgical treatment.	thin, thick or combined
post-operative pain at donor site	From one week post-operative till three months post-operative.	Post-operative pain at the donor site will be assessed by the patient using the Visual Analogue Scale (VAS), ranging from 0 (no pain) to 10 (worst imaginable pain). A higher score indicates greater pain experienced by the patient.
post-operative pain at lower front	From one week post-operative till three months post-operative.	Post-operative pain at lower front will be assessed by the patient using the Visual Analogue Scale (VAS), ranging from 0 (no pain) to 10 (worst imaginable pain). A higher score indicates greater pain experienced by the patient.
root sensitivity	From one week pre-operative till ten years post-operative.	Root sensitivity is assessed using the Visual Analogue Scale (VAS), ranging from 0 (no sensitivity) to 10 (extreme sensitivity), based on a tactile test with controlled air flow. A higher score indicates that the patient experiences greater sensitivity.
willingness to retreatment	From three months post-operative till two years post-operative.	A patient's willingness to undergo retreatment based on their previous experience with the procedure. It is assessed by using the Visual Analogue Scale ranging from 0 (not willing at all) to 10 (extremely willing). A patient reporting a higher score indicates greater willingness.