Gingival Recession
Conditions
Keywords
Free gingival graft, keratinized gingival tissue
Brief summary
This study will compare a new technique of free gingival graft to the original one, in order to evaluate the stability of the graft volume over one year and other variables. Twenty patients will receive the original technique of free gingival graft (controls) and twenty patients will receive the modified technique, in which the free gingival graft is submerged (tests), at the inferior incisors area.
Detailed description
The free gingival graft surgery is held to gain some keratinized tissue in areas where it has been lost, such as in inferior incisors with gingival recessions. In these areas, tooth brushing may become harder and painful, negatively influencing in plaque control. However, this type of graft seems to contract over time. A new approach of free gingival graft, in which the graft is covered by a flap, promises to provide greater vascularization. This would promote less graft contraction and better mucosal color. Forty patients with less than 2 mm of keratinized tissue (measured from gingival margin to mucogingival junction) in at least one inferior incisor will be included. Half will receive the original technique and half will receive the modified one. Patients will be followed at 7, 14, 21, 28, 42 days, 3, 6, 12 months and 8 years after surgeries.
Interventions
PROCEDUREFree Gingival Graft
Surgical technique (autologous graft): Free gingival graft technique, harvested from palate.
PROCEDUREOriginal Free Gingival Graft technique
Surgical technique (autologous graft): Original technique of free gingival graft, positioned at the inferior incisors area at the donor area
PROCEDUREModified Free Gingival Graft technique
Surgical technique (autologous graft): Free gingival graft. positioned at the inferior incisors area and covered by a flap at the donor area
Sponsors
Universidade Estadual de Maringá
University of Sao Paulo
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Reduced keratinized tissue (less than 2 mm) in inferior incisors area * Healthy periodontium in inferior incisors area * Indication for surgery (e.g. pain during tooth brushing, gingival margin mobility, gingival recession...) * Recessions class I, II or III, maximum 3 mm * Having signed the informed consent
Exclusion criteria
* Systemic diseases * Smokers * Pregnant and lactating women * Root caries lesions * Previous surgeries at same area * Accentuated root abrasion * Malpositioning teeth * Residual pocket depths greater than 4 mm * Tooth mobility greater than 1
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Apical-cervical width of keratinized tissue after 12 months | 12 months | Distance between gingival margin and mucogingival junction, in millimeters |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Keratinized tissue area | 12 months | Keratinized tissue area, measured in millimeters |
| Keratinized tissue thickness | 12 months | Keratinized tissue thickness measured in millimeters |
| Volume of receiving area | 12 months | Volume of receiving area |
| Complete epithelization of donor area | 28 days | Area of Epithelization of wound healing, measured in mm2 |
| Postoperative discomfort | 28 days | discomfort measured using Visual Analogue Scale |
| Probing Depth | 12 months | Distance between gingival margin and bottom of the sulcus / pocket, in millimeters |
| Oral Health Related Quality of Life (OHIP) | 12 months | OHIp - 14 short version |
| Clinical Attachment Level | 12 months | Distance between cementum-enamel junction and bottom of sulcus / pocket, measured in millimeters |
| Recession | 12 months | Distance between cementum-enamel junction and gingival margin, measured in millimeters |
| Bleeding on probing | 12 months | percentage of sites which bled upon probing |
| Gum color | 12 months | Measured with photographic analysis |
Countries
Brazil
Outcome results
None listed