Comparison of minimally invasive coronally advanced flap and modified coronally advanced flap for the management of multiple adjacent gingival recession defects: A split mouth randomized control trial

Abstract

Introduction Various minimally invasive surgical approaches are proposed for the management of gingival recession. A modified surgical approach coined as minimally invasive coronally advanced flap (MICAF) was compared with modified coronally advanced flap (MCAF) for the management of multiple adjacent gingival recession defects. Materials and methods Seven systemically healthy subjects with bilateral multiple adjacent maxillary facial gingival recession defects (Miller I) were included in this study. In each patient, MICAF performed on one side and on the other side MCAF was performed. Comparisons of the surgical sites were made with clinical measurements at 6 months follow‐up. Results No statistically significant differences were observed between MICAF and MCAF sites in the change in gingival recession depth, gingival recession width, clinical attachment level, width of the keratinized tissue, mean, and complete root coverage after 6 months. However, patient reported outcomes of esthetics and postoperative morbidity were statistically significant (P <0.001) between the MICAF and the MCAF sides with better results in the MICAF side. Conclusions Within the confines of this study, the results depicted that MICAF is more patient‐friendly procedure with better patient acceptance. Further, long‐term studies with more sample sizes are needed for a stronger evidence base. Clinical Significance Miller Class I gingival recessions can be treated with the MICAF with successful clinical outcomes and patient acceptance. This paper reports the clinical and patient reported outcomes of the MICAF and the MCAF.

Comparative evaluation of pinhole surgical technique with and without A‐PRF in the treatment of multiple adjacent recession defects: A clinico radiographic study

“…In the present study in both groups the parameters of PD, CAL, GRD and GRW exhibited reduction in values at both the time points of 6 and 12 months with the Test group indicating greater reductions than the Control group. Amongst these parameters, the more relevant from the patient's point of view were the GRD and GRW as they are clinically noticeable and are directly reflective on the aesthetic component during function.The above findings are somewhat similar to those reported by Rajendran et al10 wherein the authors compared minimally invasive coronally advanced flap with the modified coronally advanced flap and secured a difference of 2.22 ± 0.17 mm of GRD and 3.05 ± 0.49 mm between the baseline and 6 months postoperative measurements. Although the difference of these parameters achieved in the present study seems to be less at 1.29 ± 0.69 mm and 0.98 ± 0.30 mm for Test and Control groups respectively, however, the reason for this is the fact that above referenced study included only Millers class I defects only while in the present study RT1 defects were included.…”

Study design and primary outcome in randomized controlled trials in periodontology. A systematic review

“…The 318 included papers reported studies carried out in 46 different countries and published between 2018 and 2020. The total number of patients included ranged from 7 (Rajendran et al 2018) to 1877 (Ramsay et al 2018). A total of 62 papers (19.5%) were published in journals with IF < 1, 213 papers (66.9%) in journals with IF 1-4 and 43 papers (13.5%) in journals with IF > 4. study design was clearly reported in the paper, and how study design was interpreted by the reviewers (if not reported).…”

Avaliação comparativa entre matriz xenógena e enxerto de tecido conjuntivo subepitelial no tratamento de recessões múltiplas em área estética: estudo clínico randomizado controlado

“…Dessa forma, diversas técnicas cirúrgicas foram propostas para o tratamento das RGs, podendo estar ou não associadas ao ETCS e/ou biomateriais. A técnica de ACR têm sido uma das técnicas mais estudadas para o tratamento das RGs, sendo que evidências cientificas mostram que o ACR isolado promove resultados satisfatórios de redução da recessão gengival (RRG) (RAJENDRAN, et al, 2018;CAIRO, et al, 2017). , et al,2009).…”

“…Outros estudos na literatura corroboram com a percepção de 1mm como a diferença clínica mínima entre grupos (MCGUIRE & SCHEYER, 2010;RAJENDRAN, 2018).…”

“…Outro questionamento importante sobre o defeito de RGs múltiplas é o número de RGs adjacentes, as quais são caracterizadas como múltiplas. Vários estudos na literatura consideram diferentes quantidades de RGs como sendo um defeito de RGs múltiplas (GRAZIANI, et al, 2014;AHMEDBEYLI, et al, 2014;RAJENDRAN, et al, 2018). De fato, 2 RGs não podem ser consideradas como um defeito unitário, todavia, as dificuldades técnicas, inerentes ao tipo extenso de defeito, tendem a ser exacerbadas com a presença de 3 ou mais RGs adjacentes.…”