Controlled Clinical Evaluation of the Subpedicle Connective Tissue Graft for the Coverage of Gingival Recession

Abstract

The purpose of this study was to clinically evaluate the 1-year coverage of gingival recessions by a subpedicle connective tissue graft according to the original technique compared to untreated recessions by measuring probing sulcus depth (PSD), height of keratinized tissue (HKT), and mucogingival junction location changes. Paired gingival recessions were selected in 15 patients. In each patient, one recession was randomly assigned for treatment (test group) and the other recession was left untreated (control group) for 1 year. Surgery consisted of a connective tissue graft covered by a double papilla full thickness flap. Height of recession (HR), PSD, HKT, and cemento-enamel junction to mucogingival junction distance (CEJ-MGJ) were recorded with a calibrated probe before surgery and 1 year postoperatively. The control group showed no statistically significant differences in any of the parameters. In the test group, HR mean decreased significantly (P < 0.0006) from 3.66 mm to 1.09 mm, representing a mean root coverage of 70.5%. HKT mean increased significantly (P < 0.0006) from 1.60 mm to 4.30 mm, and PSD mean showed no statistical difference. CEJ-MGJ remained statistically unchanged. The subpedicle connective tissue graft may provide a good amount of root coverage and a substantial increase of keratinized tissue. Connective tissue grafted beneath the alveolar mucosa does not induce its transformation into keratinized gingival tissue.

Comparison of 2 Techniques of Subepithelial Connective Tissue Graft in the Treatment of Gingival Recessions

“…4 The predictability of the multiple surgical variants of subepithelial connective tissue grafts (SCTGs) and the mucogingival changes associated with these procedures following treatment of human gingival recessions have been documented in numerous studies. [5][6][7][8][9][10][11][12][13][14][15][16][17] Various clinical investigations reported an increase in gingival width following treatment of recession defects with subepithelial connective tissue graft combined with coronally positioned flaps. [10][11][12][13][14][15][16][17] However, no attempt has been made in these studies to justify this increase in gingival width or correlate the increase to surgical parameters.…”

Simultaneous Application of Combination of Three Surgical Techniques for Treatment of Gingival Recession: A Case Report

“…In many cases, more than one procedure is necessary to treat gingival recession. Consequently, the combination of two or more procedures has been increasingly used to provide successful results 5,19,21) . According to the literature, many factors influence the level of success of each procedure, among which interproximal bone level and selection of the most adequate technique for a particular case are the most important 11) .…”

Treatment of gingival recession

“…Root coverage averaged for 43% for the free gingival graft group, and 80% for the connective tissue graft group. Borghetti and Louise, 34 in their split-mouth controlled clinical study, reported a 70% success rate of root coverage 1 year postoperatively.…”