V-Reverse Suture Technique Compared to Traditional Anchored Sling Suture in Treating Multiple Gingival Recession

NCT07602829 | Active Not Recruiting

• 1 other identifier: 20240614
• Study Type: interventional
• Target: 7
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this split-mouth pilot study is to study the effect of two different suturing techniques in root coverage using coronally advanced flap tunnel in multiple adjacent recession cases to see which technique will give superior outcomes in term of mean root coverage percentage, and root coverage esthetic score after 3-months. The main questions it aims to answer are:

• Does a suturing technique gives superior mean root coverage percentage over another?
• Does a suturing technique gives superior root coverage esthetic score? Researcher will compare between V-reverse suturing technique and anchored sling suture to see which will result in superior mean root coverage percentage, and root coverage esthetic score after 3-months. Participants will:
• Come in for a first visit to check your gum health, check eligibility and to be provided with scaling and polishing if needed.
• Come in for surgery and clinical measurements.
• Participant will be asked to complete post-operative questionnaire for 14 days.
• Re-evaluated after 1 week and suture removal at 2 weeks.
• Follow-up after 1 and 3 months.

Conditions

Gingival Recession, Mucogingival Surgery

Keywords

plaque index; Bleeding On Probing; Gingival Recession; Multiple Adjacent Gingival Recession; V-reverse suture; anchored sling suture; mean root coverage; root coverage esthetic score; complete root coverage; keratinized tissue width; gingival thickness; probing depth; recession depth; root coverage; coronally advanced tunnel; patient-reported experience measures; pilot study; split-mouth; gingiva; periodontium

Outcome Measures

Primary Outcomes (2)

• mean root coverage percentage

  It represents the average percentage of the initial recession depth that has been successfully covered by new gum tissue over a defined period.

  3 months

• root coverage esthetic score

  (RES) is a, 10-point, five-variable system developed by Cairo et al. (2009) to objectively evaluate the success of gingival recession treatment. It evaluates root coverage (60% weight, 0-6 points) and four soft tissue parameters: margin contour, tissue texture, junction alignment, and color (40% weight, 1 point each).

  3 months

Secondary Outcomes (8)

• Percentage of complete root coverage

  3 months

• change in keratinized tissue width

  at baseline and 3 months

• change in gingival thickness

  at baseline and at 3 months

• change in recession depth

  at baseline, 1 month, and 3 months

• Patient reported experience measures (PREMs)

  For 14 days after surgery

Study Arms (2)

Test: V-Reverse Suture

EXPERIMENTAL

Coronally advanced tunnel with V-reverse suture.

Procedure: coronally advanced tunnel with v-reverse suture

Control: Anchored Sling Suture

ACTIVE COMPARATOR

Coronally advanced tunnel with anchored sling suture

Procedure: coronally advanced tunnel with anchored sling suture

Interventions

coronally advanced tunnel with v-reverse suture PROCEDURE

The V-reverse suturing technique can be a valid technique for improving graft and flap stability in the midfacial region which is likely the most crucial area that should be firm for achieving complete root coverage following the tunnel approach. The V-reverse suture starts in the palatal aspect, passing below the splinted contact point. Then the needle engages the graft and the flap (from inside to outside) ≈3 mm apical to the soft tissue margin in the mid-facial area. Then the needle passes to the palatal side under the contact point. Then the needle turns one round around the splinted composite (without pinching the soft tissue), and then the knot is performed and tightened over the composite. At the end, the sutures form a V-reverse shape

Test: V-Reverse Suture

coronally advanced tunnel with anchored sling suture PROCEDURE

In addition to interrupted sutures, sling sutures have also regularly been applied as a conventional method of suturing to advance periodontal flaps over exposed root surfaces and connect the papillae to the interdental connective tissues, and composite stops where added to provide better stability.

Control: Anchored Sling Suture

Eligibility Criteria

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

You may qualify if:

• Age ≥ 18 years
• Periodontally and systemically healthy;
• Good plaque control (FMPS \< 20%)
• Presence of two quadrants exhibiting multiple (2 or more sites) adjacent RT1 or RT2 gingival recession ≥ 2 mm in at least one site.
• Non-smoker.

You may not qualify if:

• Smoking
• Pregnant or lactating women;
• Untreated periodontitis;
• Systemic disorders with compromised healing potential;
• Use of medications (immuno-suppressants, phenytoin, or anything else that might affect soft tissue healing);
• Undergoing radiotherapy;
• History of mucogingival surgery.
• Presence of severe tooth malposition, rotation, or super-eruption.
• Presence of root caries or inadequate prosthetic restorations;
• Persistence of uncorrected gingival trauma from toothbrushing.

Sponsors & Collaborators

• King Abdullah University Hospital: lead
• Jordan University of Science and Technology: collaborator
• Deanship of Scientific Research/Jordan University of Science and Technology: collaborator

Study Sites (1)

Jordan University of Science and Technology

Irbid, Jordan, 22110, Jordan

Location

MeSH Terms

Conditions

Gingival Recession

Condition Hierarchy (Ancestors)

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

Study Officials

• Reem Abdel-Hafez

  Jordan University of Science and Technology

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, CARE PROVIDER
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor of Periodontology

Model Details: This study is conduct in a split mouth fashion, meaning each patient arch is divided into quadrants, each quadrant is then randomized to either the test or the control group. Therefore, the study is considered a parallel-group (within-subject) design in terms of participant recruitment, because each subject receives two experimental interventions. However, from an intervention and randomization perspective, it is a comparative trial where the mouth is divided into quadrants (e.g., left and right) that are randomly assigned to different suturing techniques.

Study Record Dates

• First Submitted: May 3, 2026
• First Posted: May 22, 2026
• Study Start: April 1, 2025
• Primary Completion: March 23, 2026
• Study Completion (Estimated): June 1, 2027
• Last Updated: May 22, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
• Time Frame: 12 months after publication of primary results and will remain available for 5 years via a controlled access repository upon request and data use agreement.
• Access Criteria: Qualified researchers affiliated with academic institutions, healthcare organizations, or nonprofit research centers will be able to request access to the de-identified individual participant data (IPD) and supporting documents, including the Study Protocol, Statistical Analysis Plan (SAP), and Analytic Code. Requests for access will be reviewed by the study sponsor or data access committee to ensure appropriate use and ethical standards. Approved users will receive access via a secure online data repository, after signing a data use agreement that outlines terms of use, privacy protections, and publication rights.

Locations

JO (1)