Modified Sling and Conventional Suture Techniques in Free Gingival Graft Operations
Condition: Gingival Recession, Localized
MeSH terms: Gingival Recession
Study type: Interventional

Summary: 
      The aim of this study is to investigate the effects of conventional suture (CS) and modified
      sling suture (MSS) techniques, applied in free gingival graft (FGG) surgery using gingival
      unit graft (GUG) and conventional graft (CG) techniques, on clinical parameters and graft
      dimensions.
    

Detailed description: 
      Background: The aim of this study is to investigate the effects of conventional suture (CS)
      and modified sling suture (MSS) techniques, applied in free gingival graft (FGG) surgery
      using gingival unit graft (GUG) and conventional graft (CG) techniques, on clinical
      parameters and graft dimensions.

      METHODS: 52 individuals having Cairo Type 2 (RT2) and Type 3 (RT3) gingival recessions in
      mandibular anterior region were divided into four groups as a) GUG+MSS (n=13), b) GUG+CS
      (n=13), c) CG+MSS (n=13) and d) CG+CS (n=13). Keratinized gingival width (KGW), keratinized
      tissue thickness (KGT), relative gingival recession height (rGRH), and relative vestibule
      depth (rVD) measurements were recorded using a digital caliper and periodontal probe UNC 15.
      Dimensional changes (Δ) of the graft surface area (GSA) was determined by ImageJ software.
      All measurements were done at baseline and repeated 1st and 3rd months.
    

Intervention name(s): gingival unit graft+modified sling suture technique; Gingival unit graft and conventional suture technique; Conventional graft and modified sling suture technique; Conventional graft and conventional suture technique
Intervention type(s): Procedure; Procedure; Procedure; Procedure
Intervention description(s): The GUG was obtained from the maxillary premolar area. A sulcular incision including the marginal gingival tissue, and two vertical incisions, including the distal and mesial papillae, was made in the palatial parts of the premolars. Then, the incision lines were combined and a 1-1.5 mm thick graft of the desired dimensions was dissected. The dissected graft was fixed to the recipient site with 5/0 polypropylene suture using a modified sling suture technique. First, the needle was passed through the graft slightly apical to the mesial papilla on the buccal side and removed from the lingual aspect including lingual papilla. Subsequently, on the distal side, the needle was passed from the lingual side to the buccal side, and it was passed through the graft slightly apical to the distal papilla and removed from the lingual gingiva again. Then it was knotted on the buccal graft by returning to the buccal starting point on the mesial side.; The GUG was obtained from the maxillary premolar area. The dissected graft was fixed to the recipient site with 5/0 polypropylene suture using conventional suture technique. Conventional suture technique includes a horizontal matrix suture and 2 simple sutures. First the coronal part of the dissected graft was fixed to the recipient bed with a horizontal matrix suture, then with 2 simple sutures along the vertical incision line from mesial and distal sides with 5/0 polypropylene suture.; Conventional graft dimensions were determined with aluminum foil and the foil was placed in the palatinal region at the level of the maxillary premolars, at least 2 mm away from the free gingival margin of the adjacent teeth. The exterier edges of the foil were drawn with a scalpel and the 1-1.5 mm thick graft was dissected from the donor site. The dissected graft was fixed to the recipient site with 5/0 polypropylene suture using a modified sling suture technique.; Conventional graft obtained from the palatinal region at the level of the maxillary premolars, at least 2 mm away from the free gingival margin of the adjacent teeth. The dissected graft was fixed to the recipient site with 5/0 polypropylene suture using conventional suture technique.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Gingival unit graft; Sling suture; Shrinkage