Root coverage with tunneling technique or modified advanced flap associated with acellular dermal matrix: results from 6 months randomized clinical trial

Ramos, Umberto Demoner; Bastos, Gabriel Figueiredo; Costa, Camila Alves; Souza, Sérgio Luı́s Scombatti de; Taba, Mário; Novaes, Arthur B.

doi:10.1007/s00784-021-04055-8

Cited by 6 publications

(11 citation statements)

References 22 publications

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“…Twelve studies included in the review were RCTs, and only one was a CCT. Each study compared the CAF technique with the TUN technique, eight with a connective tissue graft (CTG) [ 25 , 26 , 36 , 37 , 38 , 39 , 40 , 41 ], four with a PolS (acellular dermal matrix) [ 42 , 43 , 44 , 45 ] and one study employed the CAF technique with an enamel matrix derivative (EDM) as the test group and the TUN technique with a CTG as the control group [ 45 ]. The main characteristics of the studies included in this systematic review and meta-analysis are displayed in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

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Treating Gingival Recessions Using Coronally Advanced Flap or Tunnel Techniques with Autografts or Polymeric Substitutes: A Systematic Review and Meta-Analysis

et al. 2022

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Gingival recessions are a prevalent oral mucosa alteration. To solve this pathology, palatal mucosa or polymeric soft tissue substitutes are used when performing coronal advanced flap (CAF) or tunnel (TUN) surgical techniques. To evaluate which is the most successful approach, a literature review and meta-analysis were conducted. For the electronic search the National Library of Medicine, the Cochrane Oral Health Group Trials Register, EMBASE and WOS were used. Pooled data for the percentage of root coverage was collected and weighted means were calculated. Heterogeneity was determined using the Higgins (I2) statistic and a random-effects model was applied. Thirteen studies were included in the systematic review (12 randomized and 1 controlled clinical trials) in which both techniques (394 patients) were compared with a follow-up of 4 to 12 months. Galbraith and Baujat plots were used to control for the presence of potential outliers. After performing the meta-analysis (11 studies), the mean root coverage was similar when using the TUN or CAF techniques (p = 0.49). The only differences between the two were found for single recessions, where CAF offered a higher percentage of root coverage (mean difference = 4.98%; p = 0.006). There were no differences when applying an autograft or a polymeric substitute with either of the two tested surgical techniques (p = 0.445).

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Section: Resultsmentioning

confidence: 99%

“…Regarding KTW, only seven studies examined this parameter. Six of them [ 25 , 35 , 38 , 39 , 40 , 45 ] declared a higher KTW for the TUN group (2.6 mm to 0.33 mm) compared to the CAF (1.68 mm to −0.36 mm) group. Only Ozenci et al [ 42 ] reported that KTW was higher for the CAF group (1.25 mm) than the TUN (0.87 mm) group.…”

Section: Resultsmentioning

confidence: 99%

Treating Gingival Recessions Using Coronally Advanced Flap or Tunnel Techniques with Autografts or Polymeric Substitutes: A Systematic Review and Meta-Analysis

et al. 2022

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“…Studies were conducted in the United States [ 17 , 21 ], Brazil [ 16 , 20 ], and Turkey [ 19 ]. The age range was 18–56 years.…”

Section: Resultsmentioning

confidence: 99%

“…The main Miller class described across trials was I or II buccal GR localized at upper incisors, canines, or premolars. One study compared TUN + CTG vs. CAF + CTG [ 20 ] and four studies compared TUN + ADM vs. CAF + ADM [ 16 , 17 , 19 , 21 ].…”

Section: Resultsmentioning

confidence: 99%

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Efficacy of Tunnel Technique (TUN) versus Coronally Advanced Flap (CAF) in the Management of Multiple Gingival Recession Defects: A Meta-Analysis

Mayta-Tovalino

Barboza

Pasupuleti

et al. 2023

International Journal of Dentistry

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Objective. We systematically assessed the efficacy of tunnel technique (TUN) vs. coronally advanced flap (CAF) in the management of multiple gingival recession defects in adults. Methods. Five databases were searched until September 2021 for randomized controlled trials (RCTs) assessing TUN vs. CAF; grafts of interest were acellular dermal matrix (ADM) and connective tissue graft (CTG). Primary outcomes were root coverage (RC) and complete root coverage (CRC). Secondary outcomes were clinical attachment level (CAL), keratinized tissue width (KTW), probing depth (PD), and recession coverage (REC). Effect measures were risk ratio (RR) or mean difference (MD) with their confidence intervals (95% CI). Inverse variance methods and random-effects model meta-analyses were used. Subgroup analyses by the type of graft were performed. Quality of evidence was assessed using GRADE methodology. Results. Five RCTs (n = 173) were included, with a follow-up of 6 months for all outcomes. In comparison to CAF, TUN did not significantly reduce CRC (RR 0.65; 95% CI 0.002–176.7; p = 0.51 ) and did not increase RC (MD 0.99%; 95% CI −6.7 to 8.6; p = 0.80 ). In comparison to CAF, TUN showed no significant reduction of secondary outcomes. Subgroup analyses by type of graft showed no differences in comparison to primary analyses for primary and secondary outcomes. Three RCTs had a high risk of bias, and five RCTs had very low quality of evidence for all outcomes. Conclusions. In adults with gingival recessions, TUN had similar primary and secondary outcomes in comparison with CAF. Subgroup analyses by the type of graft did not affect main conclusions. More RCTs with better design are needed to further characterize the effects of TUN vs. CAF in the treatment of multiple gingival recession defects.

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Evaluation of healing dynamics in root coverage therapy: A systematic review of digital technologies

Abrahamian,

Brancacci,

Palacios-Bañuelos

2024

Dentistry Review

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Root coverage with tunneling technique or modified advanced flap associated with acellular dermal matrix: results from 6 months randomized clinical trial

Cited by 6 publications

References 22 publications

Treating Gingival Recessions Using Coronally Advanced Flap or Tunnel Techniques with Autografts or Polymeric Substitutes: A Systematic Review and Meta-Analysis

Treating Gingival Recessions Using Coronally Advanced Flap or Tunnel Techniques with Autografts or Polymeric Substitutes: A Systematic Review and Meta-Analysis

Efficacy of Tunnel Technique (TUN) versus Coronally Advanced Flap (CAF) in the Management of Multiple Gingival Recession Defects: A Meta-Analysis

Evaluation of healing dynamics in root coverage therapy: A systematic review of digital technologies

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