Two Different Graft Harvesting Techniques Applied in Localized Gingival Recessions

Study Overview
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Brief Summary
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The primary purpose of this study is to compare the root coverage rate of the gingival unit-shaped connective tissue graft, obtained by intraoral de-epithelization, with the traditional de-epithelialized free gingival graft in localized recessions of anterior and premolar teeth. In addition, it is aimed to compare the postoperative gingival thickness between the two techniques. The secondary aim is to search the effects of both techniques on periodontal parameters and to evaluate patient-centered outcomes.

Official Title
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Clinical Comparison of Two Different Graft Harvesting Techniques Applied in Localized Gingival Recessions

Conditions
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Gingival Recession, Localized, Sensitivity, Tooth, Attachment Loss, Periodontal

Intervention / Treatment
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* Procedure: Coronally advanced flap with connective tissue graft


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: American Society of Anesthesiologists physical status class 1 and 2 patients,healthy patients Nonsmokers Periodontally healthy patients Localized gingival recessions (Miller I, II, and Cairo I recessions with a depth of recession of at least 2 mm) in anterior and premolar teeth Exclusion Criteria: Medically compromised patients, especially uncontrolled diabetes Pregnancy, lactation, or suspicion of pregnancy, Poor oral hygiene Recessions associated with caries or restoration

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: De-epithelialized gingival unit graft<br>In this split-mouth randomized controlled trial, the coin toss method will determine test and control groups. In both groups, connective tissue graft with a trapezoidal flap design will be applied to the recession area. To obtain the connective tissue graft, the gingival unit graft will be de-epithelialized in the test group. | Procedure: Coronally advanced flap with connective tissue graft<br>* In both groups, connective tissue graft with a trapezoidal flap design will be applied to the recession area.<br>|
| Experimental: De-epithelialized free gingival graft<br>In this split-mouth randomized controlled trial, the coin toss method will determine test and control groups. In both groups, connective tissue graft with a trapezoidal flap design will be applied to the recession area. To obtain the connective tissue graft, the traditional free gingival graft will be de-epithelialized in the control group. | Procedure: Coronally advanced flap with connective tissue graft<br>* In both groups, connective tissue graft with a trapezoidal flap design will be applied to the recession area.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Root coverage percentage | The comparison of the postoperative recession depth to the initial recession depth | Postoperative 6th month | 
| Gingival thickness | Gingival thickness in the mid-buccal of the recession defect measured with an endodontic spreader and digital recordings | Preoperative and postoperative 6th month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Recession width | Recession width measured at the cemento-enamel junction | Preoperative and postoperative 6th month | 
| Probing depth | Probing depth measured at the mid-buccal of the recession defect | Preoperative and postoperative 6th month | 
| Clinical attachment loss | Clinical attachment loss measured at the mid-buccal of the recession defect | Preoperative and postoperative 6th month | 
| Keratinized gingiva width | Mid-buccal gingival width measured with a periodontal probe | Preoperative and postoperative 6th month | 
| Vestibular depth | The distance from the gingival margin to the greatest concavity of the mucosal fold | Preoperative and postoperative 6th month | 
| Pain perception | Visual analog scale where higher scores mean a worse outcome and has a minimum value of 0 and a maximum value of 10 | Postoperative 1st week | 
| Bleeding related to the procedure | Bleeding evaluated by a dichotomous index | Postoperative 1st week |