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Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivate for root coverage: 2‐year results of an RCT using 3D digital measuring for volumetric comparison of gingival dimensions
Author(s) -
Zuhr Otto,
Rebele Stephan F.,
Vach Kirstin,
Petsos Hari,
Hürzeler Markus B.
Publication year - 2020
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/jcpe.13328
Subject(s) - medicine , gingival recession , dentistry , connective tissue , gingival margin , enamel matrix derivative , enamel paint , root caries , soft tissue , nuclear medicine , surgery , pathology , regeneration (biology) , biology , microbiology and biotechnology
Abstract Aim The aim of this randomized clinical trial was to compare clinical and volumetric outcomes of tunnel technique (TUN) with subepithelial connective tissue graft (CTG) versus coronally advanced flap (CAF) with enamel matrix derivate (EMD) 2 years after gingival recession (GR) treatment. Materials and methods Twenty‐three patients contributed 45 Miller class I or II GR. At baseline and follow‐up examinations, study models were collected. Their three‐dimensional scans allowed precise computer‐assisted measurement of recession depth (REC), complete root coverage (CRC), percentage of root coverage (RC), pointwise (pTHK) and mean areal (aTHK) marginal soft tissue thickness. Clinical examination delivered probing depths (PPD) and height of keratinized tissue. Results 24 months after surgery, digitally evaluated CRC was present in 60.0% of the TUN + CTG and 0.0% of the CAF + EMD‐treated sites ( p < .0001), meaning a certain relapse of the gingival margin ragarding both approaches. RC amounted to 94.0% (TUN + CTG) and 57.3% (CAF + EMD), respectively ( p < .0001). REC reduction (RECred) was significantly higher for TUN + CTG (1.81 ± 0.56 mm) than for CAF + EMD (0.90 ± 0.45 mm) ( p < .0001). pTHK and aTHK values were significantly greater in the TUN + CTG group (1.41 ± 0.35 mm and 1.11 ± 0.26 mm) than in the CAF + EMD group (0.78 ± 0.32 mm and 0.60 ± 0.26 mm) ( p < .0001). Statistical analysis detected positive correlations between THK and both RC and RECred ( p < .001). Conclusions Two years post‐operatively, CTG showed better clinical and volumetric outcomes than EMD. Increased THK values were associated with improved outcomes regarding RC and RECred.