Comparison of techniques for root coverage of localized recessions: A 12-month follow-up randomized controlled trial

Abstract

Objectives To compare two techniques for the root coverage of unilateral, single type-1 gingival recessions. Materials and methods This randomized controlled trial evaluated thin-gingival phenotype individuals with unilateral and single RT1 undergoing root coverage procedures. The study compared the combinations of subepithelial connective tissue graft (SeCTG) with a coronally-advanced flap (CAF; control group) and with the tunnel technique (TT; test group). The main parameters assessed were probing depth (PD), gingival recession height (GH), keratinized tissue (KTW), gingival thickness (GT), and percentage of root coverage (RC). Patient-reported outcome measures (PROMs), such as postoperative pain, cervical dentin hypersensitivity (CDH), esthetics, satisfaction level, and quality of life were also assessed, over 12 months of follow-up. Data were statistically analyzed using paired Student’s t-test, Chi-square, McNemar, and Split-Plot Analysis of Variance with post hoc t-test (α = 5%). Results Forty-six subjects completed the study (CAF + SeCTG: 23; TT + SeCTG: 23). Significant reductions for GH and gains in CAL, KTW, and GT were observed in the intragroup analysis for both groups. No differences were found between techniques. RC increased significantly, but no intergroup differences were observed (CAF + SeCTG: 89.4%; TT + SeCTG: 87.1%; p = 0.071). Intragroup analysis indicated a modification in gingival phenotype (GP) from thin to thick (p < 0.001). Both treatment protocols improved PROMs (p < 0.001), with no differences between the techniques. Conclusions The two surgical approaches resulted in significant improvements with similar clinical efficacy regarding RC, including GH, CAL, KTW, gingival thickness, and PROMs. Clinical relevance CAF + SeCTG versus TT + SeCTG showed similar clinical, esthetic and patient-related outcomes; however, CAF + SeCTG had a shorter surgical time.