The Relationship Between Root Coverage Procedures and Buccal Vestibular Depth
Condition: Shallow Vestibular Depth; Gingival Recession
MeSH terms: Gingival Recession
Study type: Interventional

Summary: 
      In this comparative trial, 50 patients with shallow vestibules and Type 1/2 recessions will
      be treated with either a vertically coronally advanced flap + connective tissue graft or a
      free gingival graft. At baseline, 3rd-month, 6th-month, and 12th-month visits, the following
      parameters will be evaluated: buccal vestibular depth, keratinized tissue height, gingival
      thickness, recession depth, recession width, probing depth, and clinical attachment level.
      Keratinized tissue change, gingival thickness change, root coverage, clinical attachment
      gain, and complete root coverage will be calculated. The wound healing index, tissue
      appearance, patient expectations, aesthetics, and dentin hypersensitivity will be assessed at
      baseline and at the 6th week.
    

Detailed description: 
      Buccal vestibule depth was recorded using two different measurement methods. First, the
      distance between the cementoenamel junction and the deepest point of the vestibule sulcus was
      measured and recorded as VD1. Then, the distance between the gingival margin and the base of
      the vestibule sulcus was measured and recorded as VD2.
    

Intervention name(s): Vertically coronally advanced flap combined with connective tissue graft.; Free gingival graft
Intervention type(s): Procedure; Procedure
Intervention description(s): The exposed root surfaces are planed with Gracey 1-2 curettes. An intrasulcular incision is made with a blade on the buccal aspects of the involved teeth. The incision is extended horizontally to the adjacent papilla. Then, slightly divergent vertical releasing incisions are carried 2 mm beyond the mucogingival junction. A full-thickness flap is raised with a periosteal elevator towards the mucogingival junction. After that, a partial-thickness dissection is carried out in the apical direction to release muscle tension and provide coronal advancement of the flap. The adjacent papillae are de-epithelialized. The connective tissue graft (CTG) is harvested from the lateral palate using the de-epithelialized gingival graft technique. After harvesting, the connective tissue graft is sutured to the recipient bed. Finally, the flap is positioned 2 mm over the cementoenamel junction and sutured with 6-0 polypropylene sutures. No periodontal dressing is applied.; A partial-thickness flap is elevated (using a blade #15c) with horizontal incisions at the cemento-enamel junction (CEJ) level of the adjacent teeth. Then, two vertical incisions extending to the apical are made from the two ends of the horizontal incision. The epithelium in the framed region is removed with a scalpel, and the underlying connective tissue is exposed. To achieve the best vascularization of the free gingival graft from the recipient site, bed preparation is completed with a split-thickness horizontal incision that joins the vertical incisions in the apical region. The free gingival graft is stabilized using interrupted sutures and a sling suture.
Other intervention name(s): epithelialized free gingival graft
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Care Provider, Outcomes Assessor)
Primary purpose: Treatment