Gingival Recession
Conditions
Brief summary
Defects associated with severe interdental hard and soft tissue loss are challenging to the periodontist, mainly due to the increased avascular surface and the reduced interproximal periosteal bed. Reports on the surgical techniques used to address recession type 2 or 3 defects mostly showed statistics on the mid-facial root coverage that yielded outcomes that do not encompass coverage of the interdental exposed root surface which highlights areas of controversy in their use for papilla reconstruction. Several case reports and clinical studies have shown encouraging results, but the long-term data are not available in the literature yet. The novel 3D tunneling (3DT) method achieved significant clinical improvement with long term stability in a recent case series. However, additional research is needed to validate 3DT for its routine clinical use. Moreover, the 3DT method achieved a decrease in the lingual recession depth which should be pointed out that the technique also addresses lingual recession.
Interventions
PROCEDURERoot coverage
The novel 3D tunneling (3DT) method achieved significant clinical improvement with long term stability in a recent case series. However, additional research is needed to validate 3DT for its routine clinical use.
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
* Buccal and lingual multiple adjacent recession defects classified as Cairo et al RT2. * Age ≥18 years * Full mouth plaque index score less than 20% O'Leary et al. 1972 * Patients with healthy systemic condition * Clinical indication and/or patient request for root coverage
Exclusion criteria
* Patients with systemically compromised health * Periodontal surgical treatment during the previous 24 months in the involved site * Pregnant or lactating mothers * Smokers * Non-compliant patients * Restored teeth * Non-carious cervical lesion
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Gingival recession depth | From enrollment to the end of treatment at 1 year |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Gingival recession depth lingual | From enrollment to the end of treatment at 1 year | — |
| Clinical attachment level (CAL) buccal and lingual | From enrollment to the end of treatment at 1 year | — |
| Periodontal probing depth (PPD) buccal and lingual | From enrollment to the end of treatment at 1 year | — |
| Width of keratinized tissue (KTW) | From enrollment to the end of treatment at 1 year | — |
| Papilla tip to contact point distance | From enrollment to the end of treatment at 1 year | — |
| Mean root coverage | From enrollment to the end of treatment at 1 year | — |
| Root coverage esthetic score (RES) | From enrollment to the end of treatment at 1 year | The RES system evaluates five variables 1 year following surgery: GM, marginal tissue contour (MTC), soft tissue texture (STT), MGJ alignment, and gingival color (GC). GM. Zero points = failure of root coverage (gingival margin apical or equal to the baseline recession); 3 points = partial root coverage; 6 points = CRC. MTC. Zero points = irregular gingival margin (does not follow the CEJ); 1 point = proper marginal contour/scalloped gingival margin (follows the CEJ). STT. Zero points = scar formation and/or keloid-like appearance; 1 point = absence of scar or keloid formation. MGJ. Zero points = MGJ not aligned with the MGJ of adjacent teeth; 1 point = MGJ aligned with the MGJ of adjacent teeth. GC. Zero points = color of tissue varies from gingival color at adjacent teeth; 1 point = normal color and integration with the adjacent soft tissues. Thus, the ideal esthetic score is 10. |
| Post operative pain using Visual analogue scale (VAS) | From enrollment to the end of treatment at 1 year | Pain score will be reported by the patient directly through Visual Analogue Scale (VAS) score (between 0 and 10.0: no pain, 1: minimal pain, 5: moderate pain, 10: severe pain) will be recorded at day 3, day 7, and day 14. |
Countries
Egypt
Outcome results
None listed