Tuberosity Versus Palatal Connective Tissue Graft on the Treatment of Single Maxillary Recession-type Defects
NCT ID: NCT06404762
Last Updated: 2024-09-26
Study Results
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Basic Information
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RECRUITING
NA
30 participants
INTERVENTIONAL
2023-07-01
2025-02-01
Brief Summary
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Therefore, the following questions related to the study are raised:
* Do SCTGs harvested from MT (tSCTG) and LP (pSCTG) exhibit similar root coverage outcomes in the treatment of single maxillary recession-type defects using CAF?
* What are the histological characteristics of tSCTG and pSCTG?
A total of 30 patients who have been referred to the Gazi University Department of Periodontology will be randomly assigned to receive tSCTG or pSCTG in combination with CAF. Clinical measurements will be recorded at baseline, 1, 3, 6, and 12 months after surgeries. Immediately after interventions; a questionnaire evaluating post-operative pain, discomfort, sensitivity, and bleeding will be given to the patients. The amount of non-steroid anti-inflammatory drugs used will be recorded at 1, 2, 3, 7, 14 and 28 days after surgery. Descriptive morphologic analysis of the grafts will be assessed in terms of the presence of inflammatory cells, connective tissue cellularity, vascularization, adipose tissue, and collagen structure.
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Detailed Description
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CAF combined with pSCTG is considered the gold standard for root coverage procedures. However, factors such as the density of vascular structures, a close approximation to nerves, and postoperative morbidity remain concerning for clinicians using palatal connective tissue grafts. Because of this, researchers have sought different techniques for palatal connective tissue harvesting and/or different autogenous donor areas. The maxillary tuberosity region has been found to have a denser lamina propria and is farther from nerve/vascular bundles.
Despite differences in harvesting techniques, literature has presented similar root coverage outcomes, lesser post-operative bleeding, and pain for SCTGs harvested from the maxillary tuberosity (tSCTG) compared to pSCTG groups. Decreased post-operative pain after tSCTG harvesting could be explained by higher amounts of connective tissue present in the donor area after harvesting and avoiding trauma created by food consumption and tongue movements in the region. Clinical data also showed an increased amount of keratinized tissue and its stability after augmentation, favoring tSCTG. Considering structural differences, literature has shown that tSCTG provides more thickness, a more abundant lamina propria, and denser collagen compared to pSCTG. However, due to the size of the harvested tSCTG not being as abundant as pSCTG, it can be assumed that the augmented areas were limited to multiple recessions or defects.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
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tSCTG+ CAF
Single, isolated gingival recessions; excluding molars; at maxilla will be treated with subepithelial connective tissue graft harvested from the maxillary tuberosity in conjunction with a coronally advanced flap
tSCTG+ CAF
In the tSCTG group, at the distal end of a second maxillary molar, an incision will be made using a double-bladed scalpel (SKU 10-130-05D; Hu-Friedy, Chicago, IL, USA) bucco-palatally, forming a 1,5 mm thick parallel line. Secondary incisions will be made to separate the graft using a 15c blade on the buccal and palatal sides. Later, the graft will be de-epithelialized extra-orally using a blade
pSCTG+ CAF
Single, isolated gingival recessions; excluding molars; at maxilla will be treated with subepithelial connective tissue graft harvested from the lateral palate in conjunction with a coronally advanced flap
pSCTG+ CAF
In pSCTG group; the graft will be harvested through a single-incision approach at the lateral palatal mucosa
Interventions
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tSCTG+ CAF
In the tSCTG group, at the distal end of a second maxillary molar, an incision will be made using a double-bladed scalpel (SKU 10-130-05D; Hu-Friedy, Chicago, IL, USA) bucco-palatally, forming a 1,5 mm thick parallel line. Secondary incisions will be made to separate the graft using a 15c blade on the buccal and palatal sides. Later, the graft will be de-epithelialized extra-orally using a blade
pSCTG+ CAF
In pSCTG group; the graft will be harvested through a single-incision approach at the lateral palatal mucosa
Eligibility Criteria
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Inclusion Criteria
* No active periodontal disease
* Maxillary anterior and premolar teeth with single, isolated recessions RT 1 (Miller 1 \&2)
* Absences of non-carious cervical lesions (NCCL) and non-detectable cemento-enamel junction (CEJ)
* Buccal gingival recession defects between 2-5 mm in depth
Exclusion Criteria
* Intake of medications that impede periodontal tissue health and healing
* Medical contraindications for periodontal surgical procedures
* Pregnancy and lactation
* Bleeding and plaque scores ≥ 20%
* Probing depths \> 4 mm
18 Years
60 Years
ALL
Yes
Sponsors
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Gazi University
OTHER
Responsible Party
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Sıla Çağrı İşler
Assoc Prof
Locations
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Gazi University Faculty of Dentistry
Ankara, Çankaya, Turkey (Türkiye)
Countries
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Central Contacts
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Facility Contacts
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References
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Zucchelli G, Amore C, Sforza NM, Montebugnoli L, De Sanctis M. Bilaminar techniques for the treatment of recession-type defects. A comparative clinical study. J Clin Periodontol. 2003 Oct;30(10):862-70. doi: 10.1034/j.1600-051x.2003.00397.x.
Chambrone L, Tatakis DN. Periodontal soft tissue root coverage procedures: a systematic review from the AAP Regeneration Workshop. J Periodontol. 2015 Feb;86(2 Suppl):S8-51. doi: 10.1902/jop.2015.130674.
Jung UW, Um YJ, Choi SH. Histologic observation of soft tissue acquired from maxillary tuberosity area for root coverage. J Periodontol. 2008 May;79(5):934-40. doi: 10.1902/jop.2008.070445.
Zucchelli G, Mele M, Stefanini M, Mazzotti C, Marzadori M, Montebugnoli L, de Sanctis M. Patient morbidity and root coverage outcome after subepithelial connective tissue and de-epithelialized grafts: a comparative randomized-controlled clinical trial. J Clin Periodontol. 2010 Aug 1;37(8):728-38. doi: 10.1111/j.1600-051X.2010.01550.x. Epub 2010 Jun 24.
Other Identifiers
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E-21071282-050.99-519910
Identifier Type: -
Identifier Source: org_study_id
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