Evaluation of SECTG Vs. Laser-DGG in Management of Gingival Recessions.

Evaluation of Tunneling Technique With Subepithelial Connective Tissue Graft Vs. Laser De-epithelialized Gingival Graft in Management of Multiple Cairo RT-2 Gingival Recessions.

This study evaluates laser de-epithelialized gingival graft to be as effective as subepithelial connective tissue graft in management of multiple gingival recessions using tunneling technique. half pf participants will be treated from gingival recession using tunneling technique with laser de-epithelized gingival graft, while the other half will be treated using tunneling technique with subepithelial connective tissue graft.

Tunneling technique is a minimal invasive method for coronal advancement during gingival recession coverage. The technique provide better blood supply which enhances wound healing and results in successful root coverage and attachment gain. Tunneling technique is suggested to be incorporated with a soft tissue tissue for better recipient site outcome.

In a systemic review and meta-analysis conducted in 2019 there was limited evidence available comparing subepithelial connective tissue graft to the de-epithelialized gingival graft. However the de-epithelialized gingival graft showed superior mean root coverage, keratinized tissue gain and clinical attachment gain over the subepithelial connective tissue graft making it the technique of choice when incorporated with coronal advancement flap in treatment of gingival recession. Laser de-epithelization may enrich the advantages of the conventional de-epithelization method where more uniform predictable epithelization can be obtained.

Inclusion Criteria:

1. Anterior teeth and premolars with multiple Miller's Class I and II gingival recessions.
2. Identifiable cemento-enamel junction.
3. The teeth with gingival recessions are vital teeth.
4. Plaque Index and Gingival bleeding index less than 20% after phase one therapy.

Exclusion Criteria:

1. Patients with systemic diseases and medical conditions that may affect the treatment outcomes.
2. Prosthetic crown, restoration or tooth decay involving the CEJ.
3. Previous periodontal surgery in the area of interest.
4. Smokers.
5. Pregnancy.