Connective tissue graft and tunnel or trapezoidal flap for the treatment of single maxillary gingival recessions: a randomized clinical trial

Background Although ample evidence supports connective tissue graft ( CTG ) use for root coverage, there is need for research on recipient site preparation approaches. The purpose of this study was to compare the outcomes of trapezoidal coronally advanced flap ( CAF ) and coronally advanced tunnel flap ( TUN ) when used in conjunction with CTG . Methods Forty‐two patients presenting 42 single maxillary, Miller Class I and II , gingival recession defects were randomly assigned to receive either CAF  +  CTG ( N  = 21) or TUN  +  CTG ( N  = 21). Clinical, patient‐centred, and aesthetic outcomes were assessed. Results Six months postoperatively, both groups resulted in significant reduction in recession depth and increases in keratinized tissue thickness and width. CAF  +  CTG and TUN  +  CTG mean root coverage was 87.2 ± 27.1% and 77.4 ± 20.4% respectively ( p  =   0.02). Complete root coverage was achieved in 71.4% and 28.6% of defects treated with CAF  +  CTG and TUN  +  CTG respectively ( p  =   0.01). At 7 days postoperatively, TUN  +  CTG patients reported significantly less pain experience ( p  =   0.04). Both approaches reduced dentine hypersensitivity by approximately 85% ( p  <   0.05). Patient‐based aesthetic evaluation indicated significant improvement for both groups. Although patient‐ and professional‐based aesthetic assessments revealed no differences between groups, tissue texture was significantly better for TUN  +  CTG ( p  =   0.02). Conclusions For root coverage of single maxillary recession defects, CAF  +  CTG was more effective than TUN  +  CTG (ClinicalTrial.org‐ NCT 02814279).