Clinical comparison of two surgical techniques in obtaining complete root coverage of single RT1 gingival recessions.

OBJECTIVES

This study aimed to compare the efficacy of the full-thickness palatal graft technique (FTPGT) and the coronally advanced flap with subepithelial connective tissue graft (CAF + SCTG) in achieving complete root coverage (CRC) in single gingival recessions (GR).

METHODS

Forty healthy patients with a single RT1 GR were randomized into two groups: 20 treated with CAF + SCTG and 20 with FTPGT. Baseline and 12-month measurements of GR, keratinized tissue width (KTW), probing depth (PD), clinical attachment level (CAL), and gingival thickness (GT) were recorded. CRC percentage, root coverage percentage (RC%), Root Coverage Esthetic Score (RES), patient-reported outcomes (PROs), and palatal wound healing were evaluated.

RESULTS

At the 12-month evaluation, 19 patients in the FTPGT group achieved CRC compared to 12 in the CAF + SCTG group (p < 0.004). FTPGT showed significantly more GR reduction (0.7 mm ± 0.19), greater CAL gain (0.65 mm ± 0.20), increased GT (0.99 mm ± 0.27), p < 0.001, and KTW gain (2.95 mm ± 0.5), and a higher RC% (12.71 ± 3.82), p < 0.002. PROs did not significantly differ between treatments, nor did palatal healing parameters. CAF + SCTG showed superior RES scores compared to FTPGT (p < 0.0003).

CONCLUSIONS

FTPGT is more effective than CAF + SCTG in achieving CRC and improving GT, KTW, CAL gain, and GR reduction, particularly in deep recessions. CAF + SCTG provides superior esthetic outcomes. PROs were comparable between the two techniques, but palatal healing was slower in the FTPGT group.

CLINICAL RELEVANCE

FTPGT, especially in deep single recessions, could serve as an alternative to CAF + SCTG, as it is associated with greater CRC, greater GT and KTW. However, it is linked to slower healing of the palatal donor site. Clincaltrial.gov registration NCT04028037.