The Use of Coronary Displaced Flap and Deepithelialized Free Graft in the Treatment of Multiple Adjacent Gingival Recessions - A Randomized Controlled Clinical Study

Status: Recruiting
Location: See location...
Intervention Type: Procedure
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Successful treatment of multiple gingival recessions (MRG) is a major challenge in periodontal plastic surgery due to complicated predisposing anatomical features of the surrounding tissues, such as a thin gingival phenotype or a limited zone of keratinized gingiva, variations in the depth and width of adjacent gingival recessions, shallow vestibulum and coronally inserted frenums and/or plica.The application of coronary advanced flap (CAF) or tunnel technique (TUN) with connective tissue graft (CTG) gives the best results in the therapy of MRG The application of connective tissue grafts in combination with various surgical techniques is accepted as the gold standard in GR therapy. A limitation in the application of CTG is the limited region of the donor site, especially in cases where a larger dimension of the CTG is required, or if the thickness of the hard palate tissue is inadequate. Techniques for obtaining subepithelial CTG (S-CTG), whether it is the trap-door technique or the single incision technique, are often associated with postoperative pain and discomfort, as well as necrosis/dehiscence of the palatal flap at the donor site. In order to overcome these limitations and obtain a firmer and more uniform CTG, especially when the thickness of the palatal tissue is inadequate (≤2.5 mm) and when a large dimension of the graft in the apico-coronary or mesio-distal direction is required, deepithelialization of the free gingival graft has been proposed (D-FGG). D-FGG has also been shown to be less prone to postoperative contraction, as it consists predominantly of collagen-rich connective tissue from the lamina propria, while adipose/glandular tissue is minimally represented. FGG can be deepithelialized intraorally with a diamond bur or diode laser, or extraorally with a scalpel. Despite all the biological advantages of D-FGG, there is scarce evidence in the literature about its histological characteristics after intraoral and extraoral deepithelialization, as well as the clinical outcomes of grafts thus obtained in combination with CAF in the treatment of MGR. Therefore, this aims of the study are to investigate the clinical efficacy and postoperative patient morbidity using D-FGG and modified CAF in the treatment of MGR, as well as to evaluate the histological characteristics of grafts obtained using two different deepithelialization techniques.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Maximum Age: 60
Healthy Volunteers: t
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• Age between 18 and 60 years,

• Non-smokers or consumption of up to 10 cigarettes per day,

• no signs of gingival inflammation,

• Presence of at least two single-rooted teeth with type I gingival recession ≥2 mm deep on the buccal side on both sides of the jaw,

• Plaque index (PI) and gingival bleeding on provocation (BOP) \<15% and probing depth (PPD) \<3 mm,

• Absence of non-carious cervical lesions (NCL) and undetectable cemento-enamel junctionr (CEJ) at defect sites,

• No history of previous periodontal plastic surgery on the affected teeth.

Locations
Other Locations
Serbia
Natasa Nikolic Jakoba
RECRUITING
Belgrade
Contact Information
Primary
Natasa Nikolic Jakoba, DDS, PhD
natasa.nikolic.jakoba@stomf.bg.ac.rs
+381638269909
Time Frame
Start Date: 2022-11-01
Estimated Completion Date: 2034-12-10
Participants
Target number of participants: 50
Treatments
Active_comparator: extraoraly de-epithelialized free gingival graft in combination with CAF
Epithelium will be removed after harvesting the graft by using the blade. By using the blade the epithelium will be separated from the connective tissue.
Experimental: intraoraly de-epithelialized free gingival graft in combination with CAF
The epithelium will be removed prior to harvesting the graft from the palate. By using a diamond bur the epithelium will be removed until the connective tissue is exposed on the whole area of the intended graft size. Thereafter, the graft will be harvested.
Related Therapeutic Areas
Sponsors
Leads: University of Belgrade

This content was sourced from clinicaltrials.gov