Gingival Recession, Gingival Recession, Mucogingival Surgery, Root Coverage
Conditions
Keywords
root coverage, combined bilaminar tunnel technique, mucogingival surgery
Brief summary
The goal of this clinical trial is to learn if the combined bilaminar tunnel technique works to treat anatomically difficult gingival recessions. It will also explore whether anatomical factors are associated with root coverage outcomes. The main questions it aims to answer are: Does the combined bilaminar tunnel technique improve root coverage outcomes in patients with anatomically difficult gingival recessions? Are specific anatomical factors associated with root coverage outcomes after the combined bilaminar tunnel technique? Participants will: Receive root coverage surgery using the combined bilaminar tunnel technique Visit the clinic for follow-up evaluations after surgery Receive clinical measurements to assess gingival recession and root coverage outcomes Receive radiographic evaluation to assess anatomical characteristics, if clinically indicated or available
Interventions
PROCEDUREmucogingival surgery
Participants will receive root coverage surgery using the combined bilaminar tunnel technique for the treatment of gingival recession. The procedure initiates with a partial-thickness flap at the sites with the most severe recession with tunnelled coronally advanced flap(tCAF), extending from the coronal margin to the mucogingival junction (MGJ). For adjacent teeth, intrasulcular incisions are made to prepare a full-thickness flap using a tunnel knife. A de-epithelialized connective tissue graft is harvested and stabilized at the coronal portion of the recipient site to facilitate root coverage. Simultaneously, a volume-stable collagen matrix (VSCM) is placed apically within the partial-thickness flap to fill bone concavities and reduce tissue retraction forces during healing.
Sponsors
Choying Lin
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Orthodontic patients who were going to be treated with cTUN approach for soft tissue modification. * Healthy periodontal condition or well controlled periodontitis with periodontal probing depth ≦ 3mm, and absence of bleeding on probing. * Thin gingival phenotype, determined with visible metal shade\[27\] * Intact clinical and pre-surgery radiographic data (CBCT) was available, and the patient followed the recommended supportive post-surgery treatment at least 6 month after the surgery. * Informed consent had been obtained prior to the mucogingival surgery.
Exclusion criteria
* Uncontrolled systemic disease, such as hypertension, diabetes. * Untreated periodontitis * History of radiation therapy on head and neck regions. * Heavy smokers (more than 0.5 pack per day). * Patient with pregnancy or breastfeeding. * History of mucogingival surgery performed on the same site. * Patient who did not comply to the recommended supportive treatment was regarded as erratic complier.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| mean root coverage and complete root coverage rate | From enrollment to six month after receiving the treatment | Mean root coverage will be calculated as the percentage reduction in gingival recession depth from baseline to the 6 month after receiving the treatment. Gingival recession depth will be measured as the distance from the cemento-enamel junction to the gingival margin. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Correlation Between Clinical and Anatomical Factors and Baseline Recession Depth | perioperative | The correlation between clinical and anatomical factors and baseline recession depth will be assessed. Clinical and anatomical factors will include baseline keratinized tissue width, tooth angulation, depth of alveolar bone concavity, angulation of alveolar bone concavity, root prominence, buccal bone dehiscence, and buccal bone thickness. Baseline keratinized tissue width and recession depth will be measured clinically in millimeters using a periodontal probe. Tooth angulation and angulation of alveolar bone concavity will be measured in degrees on CBCT images. Depth of alveolar bone concavity, root prominence, buccal bone dehiscence, and buccal bone thickness will be measured in millimeters on CBCT images. The correlation will be evaluated using linear regression analysis. |
| Correlation Between Clinical and Anatomical Factors and Mean Root Coverage After Treatment with the Combined Bilaminar Tunnel Technique | From baseline to 6 month after treatment. | The correlation between clinical and anatomical factors and mean root coverage after treatment will be assessed. Clinical and anatomical factors will include baseline keratinized tissue width, tooth angulation, depth of alveolar bone concavity, angulation of alveolar bone concavity, root prominence, buccal bone dehiscence, and buccal bone thickness. Baseline keratinized tissue width will be measured clinically in millimeters using a periodontal probe. Tooth angulation and angulation of alveolar bone concavity will be measured in degrees on CBCT images. Depth of alveolar bone concavity, root prominence, buccal bone dehiscence, and buccal bone thickness will be measured in millimeters on CBCT images. Mean root coverage will be calculated as the percentage reduction in recession depth from baseline to 6 months after treatment. The correlation will be evaluated using linear regression analysis. |
| Association Between Clinical and Anatomical Factors and Complete Root Coverage After Treatment | From baseline to 6 month after treatment | The association between clinical and anatomical factors and complete root coverage after treatment will be assessed. Clinical and anatomical factors will include baseline keratinized tissue width, tooth angulation, depth of alveolar bone concavity, angulation of alveolar bone concavity, root prominence, buccal bone dehiscence, and buccal bone thickness. Baseline keratinized tissue width will be measured clinically in millimeters using a periodontal probe. Tooth angulation and angulation of alveolar bone concavity will be measured in degrees on CBCT images. Depth of alveolar bone concavity, root prominence, buccal bone dehiscence, and buccal bone thickness will be measured in millimeters on CBCT images. Complete root coverage will be recorded as a binary outcome, defined as the presence or absence of complete coverage of the previously exposed root surface at 6 months after treatment. The association will be evaluated using logistic regression analysis. |
Countries
Taiwan
Outcome results
None listed