Gingival Recession, Plastic Surgery
Conditions
Brief summary
the aim of the study is to evaluate the changes in gingival recession depth reduction following, treatment of multiple RT2 recession with tunnel coronal advanced flap in comparison to coronal advanced flap, both combined with connective tissue graft
Detailed description
Several techniques for gingival recession defects have been developed for treatment such as are pedicle soft-tissue graft (rotational flap procedures, advanced flap procedure and tunneling), free soft-tissue graft (epithelialized and subepithelial connective tissue graft) and regenerative procedures (barrier membrane or biologic mediators. The coronally advanced flap and the tunneling technique are the most commonly performed surgical approaches for treating gingival recessions. Barootchi et al. 2024 conducted a clinical study using tunnel coronal advanced flap technique(TCAF) for treating multiple RT2 gingival recession defects ,in order to combine the advantage of both better access and graft stabilization in CAF and the preservation of the integrity of the papilla and better blood supply to the graft present in tunneling technique. From the previous study it was concluded that the combination of both techniques in the same surgical design can improve both the flap and graft vascularization and enhance clinical, esthetic, and patient-reported outcomes. To our knowledge, there is no conducted randomized clinical trials comparing the tunneled coronally advanced flap technique to the coronally advanced flap for gingival depth reduction in multiple RT2 recessions. So, this clinical trial aims to address this gap of the literature.
Interventions
PROCEDURETCAF
tunnel coronal advanced flap
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients age 18 years or older. * Multiple adjacent recession defect classified as RT2. * Patients with healthy systemic condition (Mazzotti et al., 2023). * An esthetic concern or hypersensitivity associated with GR * The gingival recessions must have at least 1.5 mm of KTW. * Presence of an identified CEJ (A step ≤ 1mm of the CEJ level)
Exclusion criteria
* Full-mouth plaque and bleeding scores \>20 (O'Leary et al., 1972) * Patients with active periodontal disease; * Intake of any medications known to affect gingival homeostasis or to interfere with wound healing * Pregnancy and nursing women * Smokers: a contraindication for any plastic periodontal surgery (Khuller, 2009). * Absence of cervical restorations, crowding or malalignment
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Gingival recession depth reduction (GRD) | ONE YEAR |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of complete root coverage (CRC%) | one year | — |
| Gingival Recession width | one year | — |
| Keratinized tissue width (KTW) | one year | — |
| Probing pocket depth | one year | — |
| Percentage of mean root coverage (MRC %) | one year | — |
| Volumetric soft tissue changes | one year | — |
| Post-operative pain | 2 Week post-operative | Visual Analogue Scale (VAS) with numerical scale from 0 to 10 ('no pain' to 'worst pain imaginable') measured daily for the first 2 weeks postoperatively |
| Post-operative patient satisfaction | one year | A 3-item questionnaire will be given to the patients to be answered using a 7-point answer scale for assessing their satisfaction with the whole surgical procedure and the achieved results of the procedure performed. |
| Root coverage esthetic score | one year | 10 is the ideal esthetic score Zero points will be assigned if the final position of the gingival margin is equal or apical to the previous recession depth (failure of root coverage procedure), irrespective of color, the presence of a scar, MTC, or MGJ. Zero points will also be assigned when a partial or total loss of interproximal papilla (black triangle) occurred following the treatment |
Contacts
Primary ContactMay Mohamed Kamal
Outcome results
None listed