Gingival Recession Clinical Trial
Official title:
Comparative Evaluation of the Tunnel Technique and Free Gingival Graft in Gingival Recessions Treatment: Randomized Controlled Trial
The present study aims to compare the tunnel technique/laterally closed tunnel technique and the FGG technique in the treatment of isolate/multiple GR in the anterior region of the mandible. Furthermore, it is proposed to evaluate the effect of a gel based on hyaluronic acid and green tea on the healing of the donor area after the removal of FGG from the palate. This work is expected to contribute to the still uncertain literature on the effectiveness of the tunnel technique as an alternative to the use of FGG in the treatment of multiple GR in the mandible.
Status | Recruiting |
Enrollment | 60 |
Est. completion date | November 5, 2025 |
Est. primary completion date | November 5, 2025 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years to 60 Years |
Eligibility | Inclusion Criteria: - Age between 18 and 60 years old; - Present isolated (=4mm) or multiple GR in the anterior region of the mandible (tooth 33 to 43) Miller Class I, II or III (87) (or Recession type (RT) 1 or RT2); - Systemically healthy with no contraindications for periodontal surgery; - Probing depth of less than 3mm at the sites involved; - Selected teeth properly positioned, free from endodontic treatment, any type of restorative treatment, caries or non-carious cervical lesion Exclusion Criteria: - Participants who use tobacco or other types of drugs; - Participants submitted to periodontal treatment in the last 6 months; - Pregnant participants; - Participants who did not accept to return to follow-ups; - Participants who used antibiotics, corticosteroids, chemotherapy, immunomodulators or others that modify the periodontal therapy results during the last 6 months. |
Country | Name | City | State |
---|---|---|---|
Brazil | Universidade Federal de Alfenas | Alfenas | Minas Gerais |
Lead Sponsor | Collaborator |
---|---|
Universidade Federal de Alfenas |
Brazil,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Recession depth | Distance between cemento-enamel junction to free gingival margin. | Change from baseline recession depth at 1, 3, 6 and 12 months | |
Secondary | Recession width | Mesio-distal extent of gingival recession | Change from baseline recession width at 1, 3, 6 and 12 months | |
Secondary | Probing depth | Distance between free gingival margin to the bottom of the sulcus. | Change from baseline probing depth at 1, 3, 6 and 12 months | |
Secondary | Clinical attachment level | Distance between cemento-enamel junction to the bottom of the sulcus. | Change from baseline clinical attachment level at 1, 3, 6 and 12 months | |
Secondary | Keratinized tissue width | Distance between the most apical point on free gingival margin to the mucogingival junction. | Change from baseline keratinized tissue width at 1, 3, 6 and 12 months | |
Secondary | Gingival thickness | The measurements were registered at the mid-buccal aspect of the tooth using a endodontic file. The distance between the marker and the tip of the file will be determined using a digital caliper. | Change from baseline gingival thickness at 6 and 12 months | |
Secondary | Gingival margin position | Distance from a reference point performed on the customized stent to the gingival margin. | Change from baseline gingival margin position at 1, 3, 6 and 12 months | |
Secondary | Graft thickness after removal | Graft thickness will be assessed immediately after removal using a endodontic file in the middle of the graft. The distance between the marker and the tip of the file will be determined using a digital caliper. | Baseline | |
Secondary | Graft thickness immediately before suture | The thickness of the graft immediately before suturing will be evaluated after de-epithelialization (in the T group) and the removal of adipose tissue when present in both groups in the middle of the graft. The distance between the marker and the tip of the file will be determined using a digital caliper. | Baseline | |
Secondary | Height of keratinized tissue in graft | Apico-coronal dimension of the graft measured at the stent mark using the periodontal probe. | Change from immediate postoperative height of keratinized tissue in graft at 1, 3, 6 and 12 months | |
Secondary | Width of keratinized tissue in graft | Mesio-distal dimension of the graft in the most coronal portion of the graft using the periodontal probe. | Change from immediate postoperative width of keratinized tissue in graft at 1, 3, 6 and 12 months | |
Secondary | Graft contraction | Graft areas will be calculated by multiplying the height and width of keratinized tissue in graft. | Change from immediate postoperative graft contraction at 1, 3, 6 and 12 months | |
Secondary | Percentage of wound reduction by photographic image | The millimeter periodontal probe will be positioned next to the wound at the time of obtaining the photos to calibrate the image analysis software that will be used to calculate the total area of the wound in donor region. | Change from 3 days percentage of wound reduction by photographic image at 7, 15 and 30 days | |
Secondary | Percentage of Wound Reduction by clinical measurement | The height and width of the wound will be determined using the periodontal probe. | Change from 3 days percentage of wound reduction by clinical measurement at 7, 15 and 30 days | |
Secondary | Epithelized surface area | The epithelialization analysis will be performed using 3% oxygen peroxide to observe the presence of blistering in the wound. The absence of epithelialization will be characterized as blistering after contact of oxygen peroxide with the wound. This parameter will be noted dichotomously (presence/absence of bubbles), being noted as yes or no, respectively, in the participant's form. | Change from 3 days epithelized surface area at 7, 15 and 30 days | |
Secondary | Palatal mucosa color | The color of the palatal mucosa will be evaluated by the visual analogue scale (VAS) in comparison with the color of the adjacent and opposite mucosa. In this evaluation, on a horizontal scale, 0 points will represent lack of color correspondence, 50 points will represent average correspondence and 100 points will represent excellent color correspondence with the adjacent tissues. | Change from 3 days palatal mucosa color at 7, 15 and 30 days | |
Secondary | Postoperative complications | Presence of bleeding, swelling, infection and necrosis in the donor area will be recorded | 3 days | |
Secondary | Postoperative complications | Presence of bleeding, swelling, infection and necrosis in the donor area will be recorded | 7 days | |
Secondary | Landry index | Classify the degree of repair based on erythema, presence of granulation tissue, bleeding/suppuration, and epithelialization in the recipient area. A score of 1 to 5 is given, where 1 is associated with a very poor/inadequate repair process and 5 is excellent. | Change from 3 days landry index at 7 and 30 days | |
Secondary | Root coverage esthetic score (RES) | The RES system evaluates five variables of the recipient area including: gingival margin level, marginal tissue contour, soft tissue texture, JMG alignment and gingival color. Zero, 3 or 6 points will be used to assess the position of the gingival margin, while a score of 0 or 1 point will be used for each of the other variables. The ideal aesthetic score will be 10. | 6 months | |
Secondary | Root coverage esthetic score (RES) | The RES system evaluates five variables of the recipient area including: gingival margin level, marginal tissue contour, soft tissue texture, JMG alignment and gingival color. Zero, 3 or 6 points will be used to assess the position of the gingival margin, while a score of 0 or 1 point will be used for each of the other variables. The ideal aesthetic score will be 10. | 12 months | |
Secondary | Visual Analogue Scale (VAS) for pain | The perception of pain will be recorded using the VAS scale at the operated sites. Participants will record the level of pain in the recipient and donor areas after the procedure on a horizontal scale, where the left endpoint will mean no pain (0), the midpoint of mean pain (50 ) and the right outcome severe pain (100). | Change from 3 days VAS scale for pain at 7, 12 and 30 days | |
Secondary | Presence or absence of dentin sensitivity | Determined from the participants' responses regarding the presence or absence of sensitivity in the cervical sites. For this, it will be asked if the participant has or not dentin sensitivity after a cold or air stimulus. | Change from 1 month dentin sensitivity at 3, 6 and 12 months | |
Secondary | Visual Analogue Scale (VAS) for esthetics | Participants will be asked to express their overall satisfaction with treatment outcomes on a VAS scale, where the left endpoint will mean not at all satisfied (0), the midpoint reasonably satisfied (50) and the right endpoint extremely satisfied. satisfied (100). | 6 months | |
Secondary | Visual Analogue Scale (VAS) for esthetics | Participants will be asked to express their overall satisfaction with treatment outcomes on a VAS scale, where the left endpoint will mean not at all satisfied (0), the midpoint reasonably satisfied (50) and the right endpoint extremely satisfied. satisfied (100). | 12 months | |
Secondary | Analgesics consumption | The consumption of analgesics by the participants in the first 7 postoperative days will also be recorded. | 7 days |
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