Comparison of Different De-epithelialization Techniques of Soft Tissue Grafts.

Does the De-epithelialization Procedure Affect the Epithelial Remnants and Recession Coverage Outcomes?

In this randomized comparative controlled clinical trial, 50 patients with single recession defects with thin phenotype were treated with coronally advanced flap. The connective tissue graft was obtained by removing the keratinized layer of the tissue. Removal of the epithelium was achieved by to different approach. At first group epithelium and remnants were removed extraorally whereas others were intraorally. After the removal, obtained graft laid on a lamella, and residual keratinocytes were observed under the microscope. Amount of recession reduction recorded at the 6th week, 6th month, 12th month, and keratinized tissue height, gingival thickness, recession depth, recession width, probing depth, and clinical attachment level, were also evaluated. Keratinized tissue change, Gingival thickness change, root coverage, clinical attachment gain, and complete root coverage were calculated. Wound healing index, tissue appearance, patient expectations, aesthetics, and dentine hypersensitivity were assessed at baseline and 6th week.

Inclusion Criteria:

• Single tooth recession more than 2mm
• Gingival thickness less than 1mm

Exclusion Criteria:

• unstable endodontic conditions or presence of any restoration/abrasion,
• tooth mobility, any surgical history or gingival enlargement in the area,
• smoking
• uncontrolled systemic disease, pregnancy or use of drugs known to affect gingival conditions