Effectiveness of Meshed Connective Tissue Graft for Treatment of Multiple Adjacent Gingival Recession Defects
Study Details
Study Description
Brief Summary
The objective of this project is to evaluate short-term and 1-year outcomes of treatment of multiple adjacent gingival recession defects (MAGRD) using the modified coronally advanced tunnel (MCAT) with either conventional CTG (control group) or meshed CTG (mesh-CTG) (test group).
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Gingival recession defects (GRD) present as a partial exposure of the root surface resulting from gingival margin displacement apical to the cemento-enamel junction (CEJ). A variety of surgical methods have been reported to reestablish root coverage, including tunneling techniques and coronally and laterally advanced flaps. As thin gingival tissue is one of the predisposing factors for GRD, the adjuvant use of subepithelial connective tissue grafts (CTG) is often considered. CTG is thought to contribute to phenotype modification and stability of treatment outcomes and studies have indicated favorable esthetic results and high degrees of root coverage (documented range: 69% to 97%). The procedure does, however, require a suitable donor site. When multiple adjacent teeth exhibit GRD, the preferred surgical approach should offer the greatest root coverage while limiting drawback (i.e., patient morbidity, esthetic problems). Thus, one of the challenges related to root coverage is the scarcity of donor tissue. In cases when large CTGs are required, additional surgical procedures may even be necessary. As an alternative, modification of the harvested CTG into an expanded "mesh CTG" (mesh-CTG) has been proposed for the treatment of multiple adjacent GRDs (MAGRD). However, the effectiveness and predictability of mesh-CTG using the modified coronally advanced tunnel (MCAT) has not yet been evaluated in direct comparison to conventional CTG.
We hypothesise that no statistically significant differences will be observed in terms of %root coverage and patient satisfaction at 12 months. Subjects in the test group (mesh-CTG) will report significantly lower morbidity at 1 and 2 weeks post-surgery when compared to controls.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Active Comparator: Connective Tissue Graft A mucogingival surgery where a conventional connective tissue graft harvested from the palate is placed on a recipient site prepared for modified coronally advanced tunnel and sutured to cover multiple adjacent gingival recession defects. |
Procedure: Modified Coronally Advanced Tunnel combined with a Connective Tissue Graft
Multiple adjacent gingival recession defects will be covered by modified coronally advanced tunnel combined with a connective tissue graft harvested from the palate.
|
| Experimental: Meshed Connective Tissue Graft A mucogingival surgery where a meshed connective tissue graft harvested from the palate is placed on a recipient site prepared for modified coronally advanced tunnel and sutured to cover multiple adjacent gingival recession defects. |
Procedure: Modified Coronally Advanced Tunnel combined with a Meshed Connective Tissue Graft
Multiple adjacent gingival recession defects will be covered by modified coronally advanced tunnel combined with a meshed connective tissue graft harvested from the palate.
Device: Meshing of Connective Tissue Graft
The harvested connective tissue graft is meshed with a scalpel blade before being unfolded and placed on the recipient site.
|
Outcome Measures
Primary Outcome Measures
- Mean mid-facial recession coverage (mRC) [up to 1 year]
Percentage of the exposed tooth root covered after surgical intervention
Secondary Outcome Measures
- Complete Root Coverage (CRC) [up to 1 year]
Frequency of complete root coverage
- Changes of Keratinized Tissue Width (KTW) [up to 1 year]
Measured as the distance from the muco-gingival-junction to the gingival margin
- Changes of Gingival Thickness (GT) [up to 1 year]
Measured 3 mm apically from the free gingival margin at the mid-buccal aspect of the tooth
- Patient Morbidity [up to 2 weeks]
Measured with Visual Analogue Scale (VAS), which consists of a 10cm line, with two end points representing 0 ('no pain') and 10 ('pain as bad as it could possibly be')
- Patient Satisfaction [up to 1 year]
Measured with Visual Analogue Scale (VAS), which consists of a 10cm line, with two end points representing 0 ('not satisfied') and 10 ('satisfied as much as it could possibly be')
Eligibility Criteria
Criteria
Inclusion Criteria:
- age ≥18 years, systemically healthy, ≥3 adjacent RT1 recessions on both sides of the maxillary or mandibular arch with an apico-coronal extension (i.e. recession depth) >2 mm, Full-Mouth Plaque Score (FMPS) <20%, Full-Mouth Bleeding Score (FMBS) <20%.
Exclusion Criteria:
- pregnancy or lactation, tobacco smoking, uncontrolled medical condition, medication that can affect gingival conditions.
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Göteborg University
Investigators
- Study Chair: Jan Derks, DDS, PhD, Goteborg University
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- OCarcuac-meshCTG