Free Mucogingival Grafts, Gingival Recession, Periodontal Plastic Surgery, Root Coverage
Conditions
Brief summary
The goal of this clinical trial is to to describe and evaluate an approach, free mucogingival graft (FMG), in periodontal plastic surgery for root coverage (RC) in lower incisor gingival recessions (GR) with mucogingival conditions and deformities (MCD) that might negatively influence the outcomes of conventional RC procedures.
Interventions
PROCEDUREBuccal muco-gingival tissue graft
Recipient Site Preparation. In the GR, a sulcular incision limited to the vestibular face will be made, which will continue until reaching the tip of the buccal papillae on each side of the GR. Two vertical incisions from the base of the two papillae to the bottom of the vestibule and one horizontal incision will connect the ends of both vertical incisions to remove the pedicle tissue. The exposed root surface will be cleaned and smoothed with mini-curettes. Donor site preparation. The incisions will be made in the same way as in the recipient area, including both papillae. The vertical incision will measure the distance from the cementoenamel junction (CEJ) to the bony dehiscence in the GR tooth, plus at least 2 mm. The tissue between the incisions will be elevated fjull or partial thickness close to the bone in the keratinized portion and superficially in the mucosal portion. A soft tissue substitute will be adapted and sutured to protect the donor site.
PROCEDUREPalatal connective tissue graft
Recipient Site Preparation. In the GR, a sulcular incision limited to the vestibular face will be made, which will continue until reaching the tip of the buccal papillae on each side of the GR. Two vertical incisions from the base of the two papillae to the bottom of the vestibule and one horizontal incision will connect the ends of both vertical incisions to remove the pedicle tissue. The exposed root surface will be cleaned and smoothed with mini-curettes. Donor site preparation A connective tissue graft will be taken from the palatal area, at the level of the premolars, which will include the two papillae. The size of the graft will be the same as that of the recipient area. A soft tissue substitute will be adapted and sutured to protect the donor site, especially if there is exposed bone.
Sponsors
Universidad de Murcia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Healthy patients with deep GR associated with lower incisor MCD. * Full mouth plaque and bleeding scores were \<20%.
Exclusion criteria
Patient characteristics: * Smoking ≥10 cigarettes a day. * Medications or systemic contraindications for oral surgery. * Pregnancy. Defects: * Thin scalloped biotype (AND/OR) * Underlying bone dehiscence (AND /OR) * Generalized GR affecting most sextants.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| buccal Recession (bREC) | 12 months | Buccal recession measurement, will be assessed with a periodontal probe, measured in mmm on the buccal aspect, from the CEJ to the gingival margin zenith. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| buccal Clinical Attachment Level (bCAL) | 12 months | bCAL will be assessed with a periodontal probe, measured in mm from the CEJ to the bottom of the pocket, on the buccal aspect. |
| interproximal Clinical Attachment Level (iCAL) | 12 months | iCAL will be assessed with a periodontal probe, measured in mm from the CEJ to the bottom of the pocket, on the interproximal aspect. |
| Interproximal papilla tip location (PT) | 12 months | Taking as reference the level of the mid-axis of the tooth, PT will be measured the distance from the CEJ at the zenith of the tooth to the tip of the papilla. A positive value will be recorded when the tip of the papillae is located coronally to the CEJ and a negative value otherwise. This outcome will be assessed with a periodontal probe and measured in mmm. |
| keratinized tissue width (KT) | 12 months | KT will be assessed with a periodontal probe, measured in mm on the buccal aspect, from the gingival margin to the mucogingival line. |
| vestibule depth (VD) | 12 months | VD will be measured, from the mucosal margin to the point of greatest concavity of the mucobuccal fold. The measure will be assessed with a periodontal probe in mm. |
| Soft tissue attached to alveolar bone (STAB) | 12 months | STAB will be measured from the gingival margen to the perpendicular mucosal insertion. The measure will be assessed with a periodontal probe in mm. |
Countries
Spain
Contacts
CONTACTAntonio J Ortiz-Ruiz, MD
CONTACTJosé A Moreno-Rodríguez, DDS
Outcome results
None listed