Gingival Recession
Conditions
Keywords
gingival recession, tunnel technique, Miller Class I and II
Brief summary
Objectives: To clinically evaluate the healing of Miller Class I and II isolated gingival recessions treated with the modified tunnel approach (mTA) versus the conventional tunnel technique (cTT) in conjunction with subepithelial connective tissue graft (SCTG). Material and Methods: In this split-mouth study, thirty healthy patients exhibiting two isolating anterior Miller Class I and II gingival recessions were treated with mTA + SCTG and cTT + SCTG. Treatment outcomes were assessed at baseline, 3-months and 6-months postoperatively. The primary outcome was root coverage esthetic scores (RES).
Detailed description
Various techniques have been suggested for the treatment of isolated mandibular recessions e.g., envelope, coronally advanced flaps double pedicle flap or tunneling procedures combined with laterally positioned pedicle flaps in conjunction with SCTG. Despite the fact that the mentioned techniques appear to improve root coverage, the success in terms of complete root coverage has high variability and thus it is still unknown which approach may lead to the most predictable outcomes. The limited evidence from the literature points clearly to the clinical importance of developing new concepts for predictable of isolated mandibular recessions. The MTA is a dual flap approach; that starts with full thickness flap (avoiding papilla incision) till the level of the mucogingival junction. On reaching the level of the vestibular mucosa, a partial thickness flap is applied to undermine the base of the flap. Using this dual approach carries two main advantages: avoidance of severing the gingival blood supply through the full thickness flap, in addition to minimizing the tension on the flap tissue through using the partial thickness flap at the above-mentioned site. In this trial, the mTA has been proposed for the surgical treatment of isolated mandibular recessions due to the following advantages: 1) it avoids vertical releasing incisions. 2) it doesn't incise the papilla, which may improve the vascularization of the area plus stabilizing the soft tissue flap. 3) it is suitable to patients with thin gingival biotype.
Interventions
PROCEDUREmTA + SCTG
These recession defects will be covered by modified tunnel approach; using a full thickness flap till the level of mucogingival junction then, partial thickness flap will be applied in the vestibular mucosa. SCTG will be harvested from the palate, put on the root surface then covered by the mTA and sutured.
Sponsors
Al-Azhar University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
29 Years to 47 Years
Healthy volunteers
No
Inclusion criteria
* except for chronic periodontitis, our patients were systemically free * Two mandibular Miller Class I or II recession sites * at least 2 mm attached gingiva. * at least 3 mm depth of recession.
Exclusion criteria
* Systemic diseases. * Smokers or formal smokers * Pregnant or lactating females * History of antibiotic therapy at the last 6 months * Patients who are not willing to follow the study protocol
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The change in Root Coverage Esthetic Score | Baseline, 3 months and 6 months | This score evaluates five variables: level of the gingival margin, marginal tissue contour, soft tissue texture, mucogingival junction alignment, and gingival color. It is calculated by expert operator. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The change in percentage of root coverage | Baseline, 3 months and 6 months | The percentage of root coverage will be calculated at 3 months, then 6 months. |
| The change in depth of gingival recession | Baseline, 3 months and 6 months. | The change in depth of gingival recession will be calculated at baseline, 3 months and 6 months. |
Outcome results
None listed