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| Name | Class |
|---|---|
| Mediplus Ltd UK | UNKNOWN |
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Multiple techniques can be used for recession coverage. The most common techniques are : tunnel technique (T), coronally advanced flap (CAF) or a combination of both (TCAF). Tunnel and coronally advanced flap are frequently used in clinical practice, whereas the combined technique is a rather recent developed surgical approach.
This randomized controlled trial compares CAF and TCAF to determine which technique provides better root coverage for receding gums in the lower front teeth. The main question it aims to answer is:
- What is the average root coverage achieved with each technique in the short and long term?
This may be clinically relevant because covering gum recession can reduce tooth sensitivity, improve aesthetics and make oral hygiene easier.
Researchers will compare the coronally advanced flap (CAF = the gum is detached and repositioned higher) with the tunneled coronally advanced flap (TCAF = the gum is undermined, only partially detached and repositioned higher). In both techniques, a small piece of tissue is removed from the palate, which is used to cover the recession. The purpose of the connective tissue graft under the flap/tunnel is to increase thickness and provide support.
Participants will:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TCAF + CTG | Active Comparator | Tunneled coronally advanced flap with a connective tissue graft |
|
| CAF + CTG | Active Comparator | Coronally advanced flap with a connective tissue graft |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Coronally advanced flap with a connective tissue graft | Procedure | The gum at the recession site is detached and reattached higher (combined with a connective tissue graft). |
|
| Measure | Description | Time Frame |
|---|---|---|
| mean root coverage | The average percentage of previously exposed tooth root surface that becomes covered by gingival tissue following a root coverage procedure. | From enrollment till ten years after surgical treatment. |
| Measure | Description | Time Frame |
|---|---|---|
| complete root coverage | The percentage of teeth for which the previously exposed root surface is completely covered by gingival tissue following the surgical procedure. These teeth show no visible recession after healing. | From enrollment till ten years after surgical treatment. |
| pocket depth |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Véronique Prof. Dr. Christiaens | Contact | +32 332 40 17 | vchristi.christiaens@ugent.be |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Periodontology and Implantology of Ghent University | Recruiting | Ghent | Oost-Vlaanderen | 9000 | Belgium |
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|
| Tunneled coronally advanced flap with a connective tissue graft | Procedure | The gum at the recession site is undermined, only partially detached and reattached higher (combined with a connective tissue graft). |
|
|
The distance from the gingival margin to the bottom of the sulcus measured using a periodontal probe. |
| From enrollment till ten years after surgical treatment. |
| recession reduction | The decrease in the amount of exposed root surface after the root coverage procedure. | From enrollment till ten years after surgical treatment. |
| width of keratinized tissue | The distance from the mucogingival junction to the free gingival margin. It includes free and attached gingival tissue, measured with a periodontal probe. | From enrollment till ten years after surgical treatment. |
| gingival thickness | Thickness of the gingival tissue measured 1-2 mm apical to the gingival margin. | From enrollment till ten years after surgical treatment. |
| phenotype | thin, thick or combined | From enrollment till ten years after surgical treatment. |
| treatment time | Time in minutes from the first incision till the last suture. | Only measured during surgery in minutes. |
| post-operative pain at donor site | Post-operative pain at the donor site will be assessed by the patient using the Visual Analogue Scale (VAS), ranging from 0 (no pain) to 10 (worst imaginable pain). A higher score indicates greater pain experienced by the patient. | From one week post-operative till three months post-operative. |
| post-operative pain at lower front | Post-operative pain at lower front will be assessed by the patient using the Visual Analogue Scale (VAS), ranging from 0 (no pain) to 10 (worst imaginable pain). A higher score indicates greater pain experienced by the patient. | From one week post-operative till three months post-operative. |
| number of analgesics | The number of pain medication tablets consumed by the patient to manage post-operative pain. | From one week post-operative till two weeks post-operative. |
| score of aesthetic result | Aesthetic satisfaction based on root coverage and color match. | From six months post-operative till ten years post-operative. |
| root sensitivity | Root sensitivity is assessed using the Visual Analogue Scale (VAS), ranging from 0 (no sensitivity) to 10 (extreme sensitivity), based on a tactile test with controlled air flow. A higher score indicates that the patient experiences greater sensitivity. | From one week pre-operative till ten years post-operative. |
| willingness to retreatment | A patient's willingness to undergo retreatment based on their previous experience with the procedure. It is assessed by using the Visual Analogue Scale ranging from 0 (not willing at all) to 10 (extremely willing). A patient reporting a higher score indicates greater willingness. | From three months post-operative till two years post-operative. |
| 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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