Coronally Advanced Flap With Two Different Techniques for the Treatment of Multiple Gingival Recessions

NCT02229669 | Completed DMC

• 1 other identifier: U1111-1158-9611
• Study Type: interventional
• Target: 10
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study compared the clinical outcomes of coronally advanced flap using two different surgical strategies in the treatment of multiple gingival recessions.

Conditions

Gingival Diseases

Outcome Measures

Primary Outcomes (1)

• Change from baseline in Marginal gingival recession to 6 months

  baseline, and at 3 and 6 months post-surgery

Secondary Outcomes (4)

• height of keratinized tissue

  Baseline, 3 and 6 months

• thickness of keratinized tissue

  baseline, 3 and 6 months

• Clinical attachment level

  baseline, 3 and 6 months

• Probing deph

  baseline, 3 and 6 months

Study Arms (2)

Horizontal incisions

EXPERIMENTAL

Coronally advanced flap was performed by using horizontal interdental incisions. An initial horizontal incision was made slightly coronal to the CEJ from the distal to the mesial papilla of the teeth with the recessions. A second incision, 1 to 2 mm apart and parallel to the first incision, was made apically. A sulcular incision was made to link the second incisions and the blade was inserted extending beyond the mucogingival junction, to create a uniform split-thickness flap. The tissue between the two incisions was partially removed to obtain a uniform receptor site that permitted primary closure. Approximation sutures to place the edge of the flap at the base of the remaining papilla were performed.

Procedure: Horizontal incisions; Procedure: Oblique incisions

Oblique incisions

EXPERIMENTAL

Coronally advanced flap was performed by using oblique incisions in interdental areas, according to the technique proposed by Zucchelli \& De Sanctis (2000). Oblique submarginal interdental incisions were performed and continued with the intrasulcular incisions at the recession defects, resulting in a envelop flap that was raised with a split-full-split approach in the coronal-apical direction. During coronal advancement, each surgical papilla was dislocated with respect to the de-epithelized anatomic papilla by the oblique incisions. Interrupted sutures were performed to stabilize single surgical papilla over the interdental connective tissue bed.

Procedure: Horizontal incisions; Procedure: Oblique incisions

Interventions

Horizontal incisions PROCEDURE

Performed by using horizontal interdental incisions. An initial horizontal incision was made slightly coronal to the CEJ from the distal to the mesial papilla of the teeth with the recessions. A second incision, 1 to 2 mm apart and parallel to the first incision, was made apically. A sulcular incision was made to link the second incisions and the blade was inserted (2 to 3 mm) extending beyond the mucogingival junction (MGJ), to create a uniform split-thickness flap. The tissue between the two incisions was partially removed to obtain a uniform receptor site that permitted primary closure. Approximation sutures to place the edge of the flap at the base of the remaining papilla were performed. Passive closure of the wound margins without tension was achieved with interrupted coaptation.

Horizontal incisions; Oblique incisions

Oblique incisions PROCEDURE

Coronally advanced flap was performed by using oblique incisions in interdental areas, according to the technique proposed by Zucchelli \& De Sanctis (2000). Oblique submarginal interdental incisions were performed and continued with the intrasulcular incisions at the recession defects, resulting in a envelop flap that was raised with a split-full-split approach in the coronal-apical direction. During coronal advancement, each surgical papilla was dislocated with respect to the de-epithelized anatomic papilla by the oblique incisions. Interrupted sutures were performed to stabilize single surgical papilla over the interdental connective tissue bed.

Horizontal incisions; Oblique incisions

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Systemically healthy subjects
• Patients should have bilateral Class I and II MGRs (Miller 1985) in maxillary tooth (at least three recession-type defects affecting adjacent teeth in each side of the maxilla).
• At least 20 teeth and no sites with attachment loss and probing pocket depth (PPD) \> 3 mm.
• Full-mouth plaque and bleeding on probing of \< 20%.
• Involved tooth should present tooth vitality, absence of caries, restorations or extensive non-carious cervical lesion.

You may not qualify if:

• History of smoking.
• Antimicrobial and anti-inflammatory therapies in the previous 2 months.
• Previous mucogingival surgery at the region to be treated
• Systemic conditions that could affect tissue healing (e.g. diabetes).
• Use of orthodontic appliances.

Sponsors & Collaborators

• Paulista University: lead

MeSH Terms

Conditions

Gingival Diseases

Condition Hierarchy (Ancestors)

Periodontal Diseases; Mouth Diseases; Stomatognathic Diseases

Study Officials

• Suzana Pimentel, PHD

  Paulista University

  PRINCIPAL INVESTIGATOR

• Guilherme Barrella, MS

  Paulista University

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MS, DDS

Study Record Dates

• First Submitted: August 21, 2014
• First Posted: September 1, 2014
• Study Start: March 1, 2011
• Primary Completion: August 1, 2012
• Study Completion: July 1, 2013
• Last Updated: September 1, 2014

Record last verified: 2014-08