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Microsurgical tunneling flap procedures using connective tissue grafts (CTG) are predictable for treating teeth with gingival recessions. Enamel matrix derivatives (EMD) can be used as an alternative to the aforementioned gold standard. The aim of this study is to evaluate clinically the use of tunnel technique with EMD applied group in addition to CTG and the same technique with CTG group for the treatment of multiple gingival recessions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Recession coverage with connective tissue graft + Emdogain® | Experimental | A modified microsurgical tunnel technique by Zuhr et al. (2007). Initial sulcular incisions with a microsurgical blade are followed by a split-thickness buccal flap preparations using the tunneling knives. The preparation is extended into the mucosal tissue to gain sufficient flap mobility. The papillary regions are detached in their buccal aspects with the periosteum. The root surfaces are applied with 24% EDTA (PrefGel®, Straumann, Basel, Switzerland) for 2 minutes and then washed with saline. Subsequently, EMD (Emdogain®, Straumann, Basel, Switzerland) is applied on root surfaces. The graft is inserted into the tunnel and stabilized with absorbable suspensory sutures. The buccal flap is advanced coronally and stabilized with non-absorbable suspensory sutures. |
|
| Recession coverage with connective tissue graft | Active Comparator | Procedure: A modified microsurgical tunnel technique by Zuhr et al. (2007). Initial sulcular incisions with a microsurgical blade are followed by a split-thickness buccal flap preparations using the tunneling knives. The preparation is extended into the mucosal tissue to gain sufficient flap mobility. The papillary regions are detached in their buccal aspects with the periosteum. The graft is inserted into the tunnel and stabilized with absorbable suspensory sutures. The buccal flap is advanced coronally and stabilized with non-absorbable suspensory sutures. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| The tunnel technique for root coverage with Emdogain | Device | The tunnel technique for root coverage with Emdogain |
|
| Measure | Description | Time Frame |
|---|---|---|
| Clinical attachment level (CAL) | Distance from the cementoenamel junction to the bottom of the gingival sulcus | 6 months after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Recession height (RH) | Distance from the cementoenamel junction to the gingival margin | 6 months after surgery |
| Recession width (RW) | Distance measured horizontally at cementoenamel junction level from one border of the recession to another |
| Measure | Description | Time Frame |
|---|---|---|
| Probing pocket depth (PPD) | Distance from the gingival margin to the bottom of the gingival sulcus | 6 months after surgery |
| Root coverage esthetic score (RES) | A score including root coverage, marginal gingival tissue contour, mucogingival junction alignment, soft tissue texture and gingival colour according to Cairo et al. (1999) |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Tomasz Kaczynski, DDS | Contact | +48 22 502 20 99 | t.kaczynski@me.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw | Recruiting | Warsaw | Mazowsze | 00-246 | Poland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34431001 | Derived | Gorski B, Szerszen M, Kaczynski T. Effect of 24% EDTA root conditioning on the outcome of modified coronally advanced tunnel technique with subepithelial connective tissue graft for the treatment of multiple gingival recessions: a randomized clinical trial. Clin Oral Investig. 2022 Feb;26(2):1761-1772. doi: 10.1007/s00784-021-04151-9. Epub 2021 Aug 24. |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | May 11, 2025 | |
| Reset | May 30, 2025 |
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| The tunnel technique for root coverage without Emdogain | Device | The tunnel technique for root coverage without Emdogain |
|
| 6 months after surgery |
| Width of keratinized tissue (WKT) | Distance between the most apical point of the gingival margin and the mucogingival junction | 6 months after surgery |
| Thickness of keratinized tissue (TKT) | Thickness of the gingiva measured 2 mm apical to the gingival margin | 6 months after surgery |
| Average recession coverage (ARC) | The percentage of covered recession area | 6 months after surgery |
| Complete recession coverage | The percentage of sites with complete root coverage | 6 months after surgery |
| 6 months after surgery |
| Post surgical pain and swelling | Questionnaire about post surgical pain and swelling using a Visual Analog Scale with values 0 (no pain / swelling), 1, 2, 3, 4, 5(moderate pain/swelling), 6, 7, 8, 9, 10 (worst pain / swelling). Lower values represent lower post surgical discomfort and are considered better. | 1, 2, 4, 7 and 14 days after surgery |
| Patient's satisfaction with treatment | Questionnaire about patient's esthetic perception of gingiva and overall satisfaction using a Visual Analog Scale from 0 (dissatisfaction with esthetic outcome), 2, 3, 4, 5 (moderate satisfaction with easthetic outcome), 6, 7, 8, 9, 10 (best satisfaction with esthetic outcome). Higher values are considered better. | 6 months after surgery |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| May 11, 2025 | May 30, 2025 |
| ID | Term |
|---|---|
| D005889 | Gingival Recession |
| ID | Term |
|---|---|
| D005882 | Gingival Diseases |
| D010510 | Periodontal Diseases |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
| D055093 | Periodontal Atrophy |
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