Hyaluronic Acid With Connective Tissue Grafting for Gingival Recession

Clinical and Aesthetic Evaluation of Hyaluronic Acid in Addition to Connective Tissue Grafts in the Treatment of Gingival Recession Defects

This study evaluates whether adding 0.8% hyaluronic acid (HA) to connective tissue grafting and coronally advanced flap surgery improves clinical and esthetic outcomes in the treatment of gingival recession. Adult patients with Miller I-II or Cairo RT1 recession defects will be randomly assigned to receive CTG alone or CTG with adjunctive HA. Mean root coverage at 6 months is the primary outcome, while secondary measures include gingival thickness, clinical attachment level, esthetic scores, postoperative morbidity, and quality of life. The study aims to determine whether HA enhances soft tissue healing and root coverage predictability compared with conventional CTG.

Inclusion Criteria:

• Presence of at least one gingival recession defect classified as Cairo RT1 or Miller Class I-II with a minimum depth of 1 mm.
• Full-mouth plaque score (FMPS) and full-mouth bleeding on probing (FMBOP) < 15%.
• Detectable cemento-enamel junction (CEJ).
• Age ≥ 18 years.
• No history of prior periodontal surgical treatment.
• Sufficient mental capacity to understand the study aims and procedures explained verbally and in writing.
• Determined to be cooperative and compliant with the clinician before, during, and after the surgical procedure.

Exclusion Criteria:

• Patients younger than 18 years.
• Periodontally healthy individuals.
• Current smokers.
• History of periodontal treatment within the past 1 year.
• Use of antibiotics within the past 3 months.
• Pregnancy or breastfeeding.
• Presence of systemic diseases such as diabetes, chronic kidney failure, cancer, bleeding disorders, connective tissue diseases, or other chronic conditions; and gingival recessions classified as Cairo RT3.
• Presence of cervical caries or restorations at the defect site.