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The aim of this study is to compare the use of T-inverted shape Free Gingival Graft with Free Gingival Graft for improving the clinical attachment, gain partial root coverage, and improve Keratinized tissue width in recession type 2 /recession type 3 gingival recession defects .
Research question : In patients with RT2 / RT3 mandibular defects will the use of inverted T-shape free gingival graft differ from free gingival graft in Recession depth?
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Inverted T -Shape Free Gingival Graft | Experimental |
| |
| Free Gingival Graft | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Inverted T shape Free Gingival Graft | Procedure | the preparation of the recipient site commenced by making a horizontal incision at the mucogingival junction (MGJ) as well as two vertical incisions extending to the adjacent teeth and about 3-4 mm beyond the MGJ. A sharp split-thickness flap will be reflected, and the surfaces between these incisions will be de-epithelialized. Also, all the surfaces of the interdental papilla up to the lingual side will be de-epithelized using a 15c blade and microsurgical scissor .(Harvesting of the palatal donor site will be designed 2 mm away from the gingival margin using a template in the form of an inverted T-shape, taking into consideration the position of the greater palatine blood vessels at 5 mm. 2 mm is required for the width of the interproximal extension with 3 mm length to obtain an even thickness of 1-1.5 mm . Placement of the graft : The Inverted T FGG will be inserted between the teeth to cover interproximal tissue defect and sutured lingually into the lingual marginal gingiva |
| Measure | Description | Time Frame |
|---|---|---|
| Recession depth. | Will be measured as the distance from the CEJ to the most apical extension of the gingival margin. | baseline, 1 month , 3 months and 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Width of keratinized gingiva . | Will be measured from the MGJ to the free gingival margin. The MGJ will be identified using the roll technique. | baseline, 1 month , 3 months and 6 months |
| Recession width |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Dina Galal Hafeez | Contact | +201223996994 | dina.hafeez@dentistry.cu.edu.eg | |
| Manar El-zanaty | Contact | +201001775660 | manar.elzanaty@dentistry.cu.edu.eg |
| Name | Affiliation | Role |
|---|---|---|
| Dina Galal Hafeez, Bachelor | Cairo University | Principal Investigator |
| Manar El-Zanaty, lecturer | Cairo University | Study Chair |
| Noha Ghallab, Professor |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Dentistry, Cairo university | Cairo | Egypt |
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| ID | Term |
|---|---|
| D005889 | Gingival Recession |
| ID | Term |
|---|---|
| D005882 | Gingival Diseases |
| D010510 | Periodontal Diseases |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
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| Free Gingival Graft | Procedure | Preparation of the recipient site :Following an intrasulcular incision, 2 mm-long horizontal incisions at the level of the CEJ will be performed bilaterally. From these, vertical releasing incisions will be placed in a diverging manner, extending well into the alveolar mucosa, a thin partial thickness flap will be subsequently raised then excised. The dimension of the resulting site will be measured to obtain a rectangular foil template . Harvesting of the Graft :Using the foil template, graft dimensions will be outlined in the palate adjacent to the premolars and first molar. A partial thickness graft consisting of epithelium and a thin layer of underlying connective tissue will be harvested (intended total thickness of graft: 1.5 mm), maintaining a distance of ≥2 mm to the maxillary teeth. |
|
Will be measured as the distance from mesial and distal papillae along the CEJ
| baseline, 1 month , 3 months and 6 months |
| Gingival thickness | An endodontic file and a 3 mm diameter silicon disc stop will be used to measure gingival thickness 2mm apical to the gingival border. The file will be inserted into the soft tissue with mild pressure, perpendicular to the mucosal surface, until a firm surface is felt. The silicon disc stop will be then pressed against the soft tissue, with the coronal border covering the soft tissue boundary.GT will be measured 2 mm apical from the gingival margin | baseline, 1 month , 3 months and 6 months |
| Root coverage esthetic score | The RES system evaluated five variables 6 months following surgery: GM, marginal tissue contour (MTC), soft tissue texture (STT), MGJ alignment, and gingival color (GC). The clinical esthetic evaluation performed without magnification. Zero, 3, or 6 points were used for the evaluation of the position of the gingival margin, whereas a score of 0 or 1 point was used for each of the other variables. | baseline, 1 month , 3 months and 6 months |
| The Distance between the contact point and the top of the papilla (DCP). | Measured as the distance between contact point and the tip of the papilla (DCP) in mms using UNC periodontal probe . | baseline, 1 month , 3 months and 6 months |
| Probing Depth | The assessment of probing depth will be measured from the gingival margin to the bottom of the sulcus using a periodontal probe, rounded to the nearest millimeter. | baseline, 1 month , 3 months and 6 months |
| Gingival Index | 0 Normal gingiva.
| baseline, 1 month , 3 months and 6 months |
| Plaque Index | 0 No plaque in the gingival area.
| baseline, 1 month , 3 months and 6 months |
| Cairo University |
| Study Director |
| D055093 |
| Periodontal Atrophy |