Clinical Comparison of Two Surgical Techniques in the Treatment of Cairo RT2 Gingival Recessions Associated to Subepithelial Connective Tissue Graft: Randomized Clinical Trial

Abstract

Purpose: The treatment of advanced gingival recessions represents a clinical challenge due to lack of appropriate interdental support. The objective of this study was to compare the outcomes of root coverage in surgical techniques employed for Tunnel root coverage and Coronally Positioned Flap (CPF), both associated to Subepithelial Connective Tissue Graft (SCTG), in patients with Cairo RT2 gingival recession. 
 Methods: Forty-one Cairo RT2 recessions were selected in 18 patients divided in groups to undergo root coverage surgery. The patients were evaluated at 0, 90, and 180 post-operative days for verification of the recession height and width, probing depth, bleeding on probing, clinical attachment level, gingival thickness, and zone of keratinized tissue (P<0.05%).
 Results: There was 1.84 ± 1.03 mm gain in gingival height in the Tunnel + SCTG group, and 2.33 ± 0.90 mm in CPF + SCTG group, without statistically significant differences between groups, and the coverage average was 62%. Full coverage was obtained in 17% of recessions.
 Conclusion: The two techniques presented significant improvement in the periodontal parameters evaluated. Only the keratinized gingiva presented better outcomes in the CPF group.

Comparison Between the Use of Advanced Platelet-Rich Fibrin (A-PRF) and Connective Tissue Graft in the Treatment of Cairo Type 1 Gingival Recession Associated with the Coronally Advanced Flap

“…However, in 2018, a consensus was reached between the American Academy of Periodontology and the European Federation of Periodontology during a world workshop for the classification of periodontal and peri-implant diseases and conditions. The Cairo classification, based on the loss of interproximal insertion tissue, was introduced, comprising RT1 soft tissue recessions without interproximal insertion loss; RT2 cases with the loss of interproximal attachment, with the distance from the Cemento-Enamel Junction (CEJ) to the sulcus/pouch being less than or equal to the vestibular attachment loss (measured from the CEJ to the sulcus/pouch in the buccal socket); and RT3 interproximal attachment loss, where the distance from the CEJ to the sulcus/pouch base exceeds the vestibular attachment loss (Bin et al, 2023;Cairo et al, 2014;Nassar et al, 2022).…”

“…Indications for the treatment of gingival recessions include reduced sensitivity, a decreased risk of cervical and root caries, increased gingival banding, and improved aesthetics (Imber and Kasaj, 2021;Kassab et al, 2010;Mancini et al, 2021). Surgical therapeutic options are well-documented and have high success rates, achieving up to 100% coverage in cases of RT1 (Bin et al, 2023;Chan et al, 2015;Nassar et al, 2022).…”