Two Surgical Approaches for Root Coverage of Teeth Presenting Gingival Recession and Non-carious Cervical Lesion
Condition: Gingival Recession
MeSH terms: Gingival Recession
Study type: Interventional

Summary: 
      The aim of the present study is to compare the use of the xenogeneic graft (MC) plus coronary
      advanced flap (CAF) and the coronary advanced flap alone, both associated with the partial
      restoration of composite resin in the treatment of gingival recessions associated with
      non-carious cervical lesion.
    

Detailed description: 
      This is a prospective, parallel and controlled clinical trial. The population evaluated in
      the study was selected at Institute of Science and Technology (ICT), São José dos Campos,
      College of Dentistry.

      Sixty patients presenting gingival recession will be divided in 2 groups:

        -  Group 1 - Test: 30 gingival recessions associated with non-carious cervical lesions that
           will receive partial composite resin restoration and periodontal surgery for root
           coverage through a xenogenic collagen matrix graft (CAF + MC + R)

        -  Group 2 - control: 30 gingival recessions associated with non-carious cervical lesions
           that will receive partial composite resin restoration and periodontal surgery for root
           coverage (CAF + R) without graft.

      The surgeries, as well as all postoperative follow-up, were performed at the dental clinic of
      ICT. Two horizontal incisions were made at right angles to the adjacent interdental papillae,
      without interfering with the gingival margins of neighboring teeth. Two oblique vertical
      incisions were extended beyond the mucogingival junction, and a trapezoidal mucoperiosteal
      flap was raised up to the mucogingival junction. After this point, a split-thickness flap was
      extended apically, releasing the tension and favoring coronal positioning of the flap.The
      exposed root surface was gently scaled and planed until it became smooth in the connective
      tissue graft (CTG) group. For those allocated to CTG plus composite resin (CR) group, a
      sterile rubber dam was placed to isolate the operative field and the non-carious cervical
      lesion restoration was performed with a nanocomposite resin (Filtek Supreme - 3M - St. Paul,
      Minnesota, USA), following the manufacturer's instructions. Afterward, the both groups
      received a thin and small connective tissue graft that was sutured over the root/restoration
      surface. Then, the flap was coronally positioned and sutured to completely cover the graft.

      Clinical parameters were assessed at baseline and 3 and 6 months post-operatively.

      Statistical Analysis The null hypothesis considered in the study was the absence of
      difference in the clinical parameters between the different groups. For data analysis, the
      statistical program was used (SigmaPlot). The demographic and clinical data were compared
      between the groups using Student's t-test. The data were first analyzed for homogeneity using
      the Shapiro-Wilk test, which indicated non-normal distribution. . Those presenting
      Shapiro-Wilk p values < 0.05 were analyzed using a Friedman test (for intragroup comparisons)
      and Mann-Whitney tests (for intergroup comparisons). Patients' esthetics and discomfort
      measures using a visual analog scale (VAS) were analyzed by T-tests. The frequency of sites
      that were scored as very good or excellent in each group by qualitative cosmetic evaluation
      (QCE) analysis, the frequency of complete root coverage, bleeding on probing (BOP), and the
      presence or absence of plaque at the site were compared using χ2 tests. Intergroup root
      esthetic scale (RES) comparisons were performed with a T-test. A significance level of 0.05
      was adopted.
    

Intervention name(s): CAF; R; MC
Intervention type(s): Procedure; Procedure; Procedure
Intervention description(s): Periodontal surgical technique to treat gingival recessions.; Restorative procedure to treat tooth structure loss.; Xenogenous graft placed in the surgical site.
Other intervention name(s): Periodontal plastic surgery; Composite resin restoration (Filtek Supreme - 3M); Xenogenous collagen matrix
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment