Multiple techniques can be used for recession coverage. The most common techniques are: tunnel technique (T), coronally advanced flap (CAF) or a combination of both (TCAF). Tunnel and coronally advanced flap are frequently used in clinical practice, whereas the combined technique is a relatively recently developed surgical approach.
This randomized controlled trial compares CAF and TCAF to determine which technique provides better root coverage for receding gums at multiple adjacent teeth in the upper jaw. The main question it aims to answer is:
\- What is the average root coverage achieved with each technique in the short and long term? This may be clinically relevant because covering gum recession can reduce tooth sensitivity, improve aesthetics and make oral hygiene easier.
Researchers will compare the coronally advanced flap (CAF = the gum is detached and repositioned higher) with the tunneled coronally advanced flap (TCAF = the gum is undermined, only partially detached and repositioned higher). In both techniques, a small piece of tissue is removed from the palate, which is used to cover the recession. The purpose of the connective tissue graft under the flap/tunnel is to increase thickness and provide support.
Participants will:
* Undergo surgery (CAF or TCAF, randomly assigned) to cover recessions * Attend regular check-ups for up to 10 years after surgery * Keep a postoperative journal (recording medication use, pain levels, tooth sensitivity, etc.)
At least 18 years of age
Good oral hygiene
Presence of multiple gingival recessions in the maxilla
Good general health
Smoker
Pregnant women (assessed at each visit; if the patient becomes pregnant during follow-up, radiographs will not be taken)
Parallel
coronally advanced flap with connective tissue graft
Procedure/SurgeryThe gum at the recession site is elevated and repositioned higher, combined with a connective tissue graft.
tunneled coronally advanced flap with a connective tissue graft
Procedure/SurgeryThe gum at the recession site is undermined, only partially detached, and repositioned higher, combined with a connective tissue graft.
mean root coverage
The average percentage of previously exposed tooth surface that becomes covered by gingival tissue following a root coverage procedure.
complete root coverage
The percentage of teeth for which the previously exposed root surface is completely covered by gingival tissue following the surgical procedure. These teeth show no visible recession after healing.
pocket depth
The distance from the gingival margin to the bottom of the sulcus measured by use of a periodontal probe.
recession reduction
The change in the amount of exposed root surface after the root coverage procedure.
width of keratinized tissue
The distance from the mucogingival junction to the free gingival margin. It includes free and attached gingival tissue, measured by use of a periodontal probe.
Click on the lead sponsor to view all of their trials.
