Modified Sling and Conventional Suture Techniques in Free Gingival Graft Operations

NCT06197893 | Completed

• 1 other identifier: SSHAKILIYEVA
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to investigate the effects of conventional suture (CS) and modified sling suture (MSS) techniques, applied in free gingival graft (FGG) surgery using gingival unit graft (GUG) and conventional graft (CG) techniques, on clinical parameters and graft dimensions.

Conditions

Gingival Recession, Localized

Keywords

Gingival unit graft; Sling suture; Shrinkage

Outcome Measures

Primary Outcomes (1)

• Graft shrinkage

  The shrinkage of the graft area was calculated according to the differences between the graft area at baseline, 1st, 3rd months using ImageJ software.

  baseline, 1-, 3-months after FGG surgery

Secondary Outcomes (1)

• Keratinized tissue weight gain (KTW)

  baseline, 1-, 3-months after FGG surgery

Other Outcomes (2)

• Relative vestibule depth (rVD)

  baseline, 1-, 3-months after FGG surgery

• Probing pocket depth (PD)

  baseline, 1-, 3-months after FGG surgery

Study Arms (4)

1. GUG+MSS

EXPERIMENTAL

The GUG was obtained from the maxillary premolar area. The dissected graft was fixed to the recipient site using a modified sling suture technique.

Procedure: gingival unit graft+modified sling suture technique

2. GUG+CS

EXPERIMENTAL

The GUG was obtained from the maxillary premolar area, as detailed experimental GUG+MSS group. The dissected graft was fixed to the recipient site using conventional suture technique.

Procedure: Gingival unit graft and conventional suture technique

3. CG+MSS

EXPERIMENTAL

Conventional graft dimensions were determined with aluminum foil and the foil was placed in the palatial region at the level of the maxillary premolars, at least 2 mm away from the free gingival margin of the adjacent teeth. The dissected graft was fixed to the recipient site with 5/0 polypropylene suture using a modified sling suture technique, as detailed experimental GUG+MSS group.

Procedure: Conventional graft and modified sling suture technique

4. CG+CS

EXPERIMENTAL

The dissected conventional graft, as detailed experimental CS+MSS group, fixed recipient bed with conventional suture technique, as detailed experimental GUG+CS group.

Procedure: Conventional graft and conventional suture technique

Interventions

gingival unit graft+modified sling suture technique PROCEDURE

The GUG was obtained from the maxillary premolar area. A sulcular incision including the marginal gingival tissue, and two vertical incisions, including the distal and mesial papillae, was made in the palatial parts of the premolars. Then, the incision lines were combined and a 1-1.5 mm thick graft of the desired dimensions was dissected. The dissected graft was fixed to the recipient site with 5/0 polypropylene suture using a modified sling suture technique. First, the needle was passed through the graft slightly apical to the mesial papilla on the buccal side and removed from the lingual aspect including lingual papilla. Subsequently, on the distal side, the needle was passed from the lingual side to the buccal side, and it was passed through the graft slightly apical to the distal papilla and removed from the lingual gingiva again. Then it was knotted on the buccal graft by returning to the buccal starting point on the mesial side.

1. GUG+MSS

Gingival unit graft and conventional suture technique PROCEDURE

The GUG was obtained from the maxillary premolar area. The dissected graft was fixed to the recipient site with 5/0 polypropylene suture using conventional suture technique. Conventional suture technique includes a horizontal matrix suture and 2 simple sutures. First the coronal part of the dissected graft was fixed to the recipient bed with a horizontal matrix suture, then with 2 simple sutures along the vertical incision line from mesial and distal sides with 5/0 polypropylene suture.

2. GUG+CS

Conventional graft and modified sling suture technique PROCEDURE

Conventional graft dimensions were determined with aluminum foil and the foil was placed in the palatinal region at the level of the maxillary premolars, at least 2 mm away from the free gingival margin of the adjacent teeth. The exterier edges of the foil were drawn with a scalpel and the 1-1.5 mm thick graft was dissected from the donor site. The dissected graft was fixed to the recipient site with 5/0 polypropylene suture using a modified sling suture technique.

3. CG+MSS

Conventional graft and conventional suture technique PROCEDURE

Conventional graft obtained from the palatinal region at the level of the maxillary premolars, at least 2 mm away from the free gingival margin of the adjacent teeth. The dissected graft was fixed to the recipient site with 5/0 polypropylene suture using conventional suture technique.

4. CG+CS

Eligibility Criteria

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

You may qualify if:

• Systemically healthy individuals
• \<1 mm of attached gingiva on mandibular incisors
• PI and GI scores \<1
• Patients who had not previously undergone soft tissue surgery in the relevant area

You may not qualify if:

• Pregnant or lactating women
• Patients younger than 18 years old
• Mandibular incisors with having restoration, probing depth ≥ 3 mm, malposition and/or endodontic problem
• Maxillary premolars with gingival recession in the palatal area and/or prosthetic restoration

Sponsors & Collaborators

• Bezmialem Vakif University: lead

Study Sites (1)

Bezmialem Vakıf University

Istanbul, Turkey (Türkiye)

Location

Related Publications (1)

• Shakiliyeva S, Sahin D, Gunpinar S, Gursel M. Comparison of conventional and modified sling suture techniques in free gingival graft operations-a randomized controlled clinical trial. BMC Oral Health. 2025 Feb 21;25(1):279. doi: 10.1186/s12903-025-05456-x.

  PMID: 39984903 DERIVED

MeSH Terms

Conditions

Gingival Recession

Condition Hierarchy (Ancestors)

Gingival Diseases; Periodontal Diseases; Mouth Diseases; Stomatognathic Diseases; Periodontal Atrophy

Study Officials

• Sadiye GUNPINAR

  Bezmialem Vakif University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Periodontology specialist

Study Record Dates

• First Submitted: December 26, 2023
• First Posted: January 9, 2024
• Study Start: March 15, 2022
• Primary Completion: December 22, 2022
• Study Completion: December 22, 2022
• Last Updated: January 11, 2024

Record last verified: 2023-12

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)