Gingival Phenotype
Conditions
Brief summary
In the randomized comparative controlled trial, 50 patients with insufficient keratinized tissue at the anterior mandible were treated with either Modified coronally advanced tunnel or epithelialized free gingival graft. At baseline, 6th week, 6th month, 12th-month visits; keratinized tissue height, gingival thickness, recession depth, recession width, probing depth, and clinical attachment level, were evaluated. Keratinized tissue change, Gingival thickness change, root coverage, clinical attachment gain, and complete root coverage were calculated. Wound healing index, tissue appearance, patient expectations, aesthetics, and dentine hypersensitivity were assessed at baseline and 6th week.
Interventions
PROCEDUREEpithelialized free gingival graft
The Epithelialized free gingival graft placed on the prepared bed.
PROCEDUREModified coronally advanced tunnel technique
Connective tissue graft placed under the prepared tunnel
Sponsors
Hacettepe University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Masking description
Patients were randomly assigned into modified coronally advanced tunnel (n=25) and epithelialized free gingival graft (n=25) groups by one of the authors with an allocation ratio of 1:1 by using a computer-generated program after successful completion of phase I periodontal treatment. One calibrated author masked to the applied surgical technique recorded all clinical variables. The labeled envelope containing the intervention name was opened by the surgeon.
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* presence of at least two anterior mandibular teeth with keratinized tissue height≤1 mm with gingival thickness ≤1mm * presence of at least two recession type-1 recessions at mandibular anterior teeth and at least one recession with recession depth ≥2 mm, * aged between 18-60.
Exclusion criteria
* unstable endodontic conditions or presence of any restoration/abrasion, * tooth mobility, any surgical history or gingival enlargement in the area, * smoking or alcohol use, * uncontrolled systemic disease, pregnancy or use of drugs known to affect gingival conditions
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Gingival Thickness | Baseline | GT, measured at the midpoint location between the gingival margin and mucogingival junction, using an endodontic spreader (#25 endodontic spreader, 25 mm; D-perfect, Shenzhen, China). |
| Gingival Thickness (GT) | 6th week | GT, measured at the mid-point location between the gingival margin and mucogingival junction, using an endodontic spreader (#25 endodontic spreader, 25 mm; D-perfect, Shenzhen, China). |
| Keratinized Tissue Height (KTH) | Baseline | KTH, measured from gingival margin to the mucogingival junction (MGJ). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinical attachment level (CAL) | Baseline | Clinical attachment level (CAL), measured from the cementoenamel junction to the bottom of the gingival sulcus. |
| Keratinized tissue change (KTC) | Baseline | Keratinized tissue change (KTC), GT change (GTC), root coverage, clinical attachment gain (CAG) were calculated in millimeters and percentages. |
| Wound healing index (WHI) | 6th week | Wound healing index (WHI) was recorded two-weeks after surgery. The wound surface was visually inspected and the soft tissue healing was defined as 'uneventful' (score 1), 'slightly disturbed' (score 2) or 'poor' (score 3) based on the presence and severity of the items including patient discomfort, erythema, edema, suppuration and flap dehiscence. |
| Probing pocket depth (PD) | Baseline | Probing pocket depth (PD), measured from the gingival margin to the bottom of the gingival sulcus. |
| Dentine hypersensitivity (DH) | 6th week | Dentine hypersensitivity (DH) was evaluated with air evaporative stimulus method at baseline and T2. After placement of finger(s) for preserving the nearby teeth, the recession sites were subjected to evaporative stimulus comprised of 1-second air blast from 1 to 3 mm distance by using the air spray at 40-65 psi pressure and 19±50C. After application, the patients were requested to give a score to their DH between 0 (=no pain) and 10 (=extreme pain). |
| Patient expectations (PE) | 6th week | Patient expectations (PE) were evaluated by requesting from the patients to rate their treatment results at T2, as satisfactory or not, in terms of appearance, experience and obtained root coverage. |
| Aesthetics (A) | 6th week | Aesthetics (A) was evaluated by the patient at T1 by rating its level as excellent, good, fair or poor. |
| Tissue appearance (TA) | 6th week | Tissue appearance (TA) was evaluated by asking the patients to score the consistency, contour, color match, keloid formation degree and contiguity of their treated sites at T2. The scores were collected as points, shown in parentheses, by asking the consistency as firm (1p) or spongy (0p); contour as presence (2p) or absence (0p) of knife-edged and scalloped gingival margin; color match as excellent (3p), good (2p), adequate (1p) or unsatisfactory (0p); keloid formation degree as absent (1p) or present (0p); contiguity as the presence (-1p) or absence (0p) of each perceptible incision mark. |
| Recession Depth (RD) | Baseline | RD, measured from the cemento-enamel junction (CEJ) to the most apical extension of the gingival margin. |
| Recession width (RW) | Baseline | Recession width (RW), the distance between the mesial gingival margin and the distal gingival margin of the tooth measured from the widest point of the recession. |
Countries
Turkey (Türkiye)
Outcome results
None listed