Gingival Recession Clinical Trial
Official title:
Evaluation of Root Coverage Outcome Using a Modified Tunnel Approach Versus Tunnel Technique: A Randomized Clinical Trial
Objectives: To clinically evaluate the healing of Miller Class I and II isolated gingival
recessions treated with the modified tunnel approach (mTA) versus the conventional tunnel
technique (cTT) in conjunction with subepithelial connective tissue graft (SCTG).
Material and Methods: In this split-mouth study, thirty healthy patients exhibiting two
isolating anterior Miller Class I and II gingival recessions were treated with mTA + SCTG
and cTT + SCTG. Treatment outcomes were assessed at baseline, 3-months and 6-months
postoperatively. The primary outcome was root coverage esthetic scores (RES).
Various techniques have been suggested for the treatment of isolated mandibular recessions
e.g., envelope, coronally advanced flaps double pedicle flap or tunneling procedures
combined with laterally positioned pedicle flaps in conjunction with SCTG. Despite the fact
that the mentioned techniques appear to improve root coverage, the success in terms of
complete root coverage has high variability and thus it is still unknown which approach may
lead to the most predictable outcomes. The limited evidence from the literature points
clearly to the clinical importance of developing new concepts for predictable of isolated
mandibular recessions.
The MTA is a dual flap approach; that starts with full thickness flap (avoiding papilla
incision) till the level of the mucogingival junction. On reaching the level of the
vestibular mucosa, a partial thickness flap is applied to undermine the base of the flap.
Using this dual approach carries two main advantages: avoidance of severing the gingival
blood supply through the full thickness flap, in addition to minimizing the tension on the
flap tissue through using the partial thickness flap at the above-mentioned site.
In this trial, the mTA has been proposed for the surgical treatment of isolated mandibular
recessions due to the following advantages: 1) it avoids vertical releasing incisions. 2) it
doesn't incise the papilla, which may improve the vascularization of the area plus
stabilizing the soft tissue flap. 3) it is suitable to patients with thin gingival biotype.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Investigator), Primary Purpose: Treatment
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