Combined Bilaminar Tunnel Technique in Treating Difficult Gingival Recessions

Effectiveness of the Combined Bilaminar Tunnel Technique in Treating Anatomically Difficult Gingival Recessions: A Prospective Cohort Study

The goal of this clinical trial is to learn if the combined bilaminar tunnel technique works to treat anatomically difficult gingival recessions. It will also explore whether anatomical factors are associated with root coverage outcomes. The main questions it aims to answer are:

Does the combined bilaminar tunnel technique improve root coverage outcomes in patients with anatomically difficult gingival recessions? Are specific anatomical factors associated with root coverage outcomes after the combined bilaminar tunnel technique?

Participants will:

Receive root coverage surgery using the combined bilaminar tunnel technique Visit the clinic for follow-up evaluations after surgery Receive clinical measurements to assess gingival recession and root coverage outcomes Receive radiographic evaluation to assess anatomical characteristics, if clinically indicated or available

Inclusion Criteria:

• Orthodontic patients who were going to be treated with cTUN approach for soft tissue modification.
• Healthy periodontal condition or well controlled periodontitis with periodontal probing depth ≦ 3mm, and absence of bleeding on probing.
• Thin gingival phenotype, determined with visible metal shade[27]
• Intact clinical and pre-surgery radiographic data (CBCT) was available, and the patient followed the recommended supportive post-surgery treatment at least 6 month after the surgery.
• Informed consent had been obtained prior to the mucogingival surgery.

Exclusion Criteria:

• Uncontrolled systemic disease, such as hypertension, diabetes.
• Untreated periodontitis
• History of radiation therapy on head and neck regions.
• Heavy smokers (more than 0.5 pack per day).
• Patient with pregnancy or breastfeeding.
• History of mucogingival surgery performed on the same site.
• Patient who did not comply to the recommended supportive treatment was regarded as erratic complier.