Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivative for root coverage: a RCT using 3D digital measuring methods. Part I. Clinical and patient‐centred outcomes

Abstract

TUN resulted in significantly better clinical outcomes compared with CAF. The new measuring method provided high accuracy and unforeseen precision in the evaluation of treatment outcomes after surgical RC.

The effect of PRF (platelet-rich fibrin) inserted with a split-flap technique on soft tissue thickening and initial marginal bone loss around implants: results of a randomized, controlled clinical trial

“…Moreover, the initial thin mucosa is split into two extremely thin layers. A sufficient nutrition of the flap requires a minimum flap thickness of 0.8–1.2 mm [23, 24]. Since the blood supply of these flaps with reduced thickness cannot be provided only from the lateral, additional nutrition from the periosteum and the bone is necessary to maintain a livid flap.…”

Root Coverage Procedures for Multiple Recession Defects

“…The efficacy of enamel matrix derivative (EMD, Emdogain®, Straumann) was compared to that of SCTG in two studies. Zuhr et al compared tunnel technique with SCTG to CPF with EMD and found significantly better results in the SCTG group at 12 months (mean root coverage 98 vs. 72%) [28]; Alkan and Parlar found approximately 90% root coverage in both EMD and SCTG groups at 12 months [25]. In neither of the studies was the baseline gingival thickness reported, but Alkan and Parlar stated that they did not find any statistically significant difference in the baseline gingival thickness between groups.…”

“…Comparison of EMD to another treatment procedure was made in three out of four studies. Combination of CPF and EMD provided a comparable percent root coverage to that of CPF alone (75% for EMD and 71% for CPF alone) [39], and CPF + SCTG (89% for EMD and 93% for SCTG) [25], but a less promising outcome than tunnel technique with SCTG (72% for EMD and 98% for SCTG) [28], as discussed in previous paragraphs. In their case series report, Vincent-Bugnas et al evaluated the clinical results of the combination of tunnel technique and EMD in single and multiple gingival recession defects [50].…”

“…A total of four studies reported the clinical effectiveness of enamel matrix derivative (EMD) on multiple gingival recession defects, with mean percent root coverage ranging from 72 to 92% [25,28,39,50]. Comparison of EMD to another treatment procedure was made in three out of four studies.…”

“…Studies using subepithelial connective tissue graft (SCTG) on multiple Miller Class I and II gingival recession defects show mean percent root coverage ranging from 77 to 98%, with only 4 out of 17 studies reporting less than 90% [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Other than coronally positioned flaps, flap designs used include tunnel technique [12,13], modified coronally advanced tunnel (MCAT) technique [26], modified coronally advanced flap (MCAF) technique by Zucchelli and De Sanctis [17,29], and a modified coronally positioned flap with a horizontal incision in the alveolar mucosa [20].…”