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Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivative for root coverage: a RCT using 3D digital measuring methods. Part I. Clinical and patient-centred outcomes


Zuhr, Otto; Rebele, Stephan F; Schneider, David; Jung, Rony E; Hürzeler, Markus B (2014). Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivative for root coverage: a RCT using 3D digital measuring methods. Part I. Clinical and patient-centred outcomes. Journal of Clinical Periodontology, 41(6):582-592.

Abstract

AIM: The aim of this randomized clinical trial (RCT) was to introduce 3D digital measuring methods for evaluating the outcomes after surgical root coverage (RC) and to assess the clinical performance of the tunnel technique with subepithelial connective tissue graft (TUN) versus the coronally advanced flap (CAF) with enamel matrix derivative in the treatment of shallow localized gingival recession defects. MATERIAL AND METHODS: Twenty-four patients contributed a total of 47 Miller class I or II recessions for scientific evaluation. Clinical outcomes were evaluated at 6 and 12 months. Precise study models gained at baseline and follow-up examinations were optically scanned and virtually superimposed for digital evaluation of clinical outcome measures including percentage of RC and complete root coverage (CRC). Patient-centred outcomes were evaluated with questionnaires. Final aesthetic outcomes were assessed using the root coverage esthetic score (RES). RESULTS: At 12 months, RC was 98.4% for TUN-treated and 71.8% for CAF-treated defects (p = 0.0004). CRC was observed in 78.6% (TUN) and 21.4% (CAF) of the cases (p = 0.0070). Results for patient-centred outcomes were equivalent for both groups but evaluation of the final aesthetic outcomes using the RES revealed a significant difference (9.06 versus 6.92, p = 0.0034) in favour of TUN. CONCLUSIONS: TUN resulted in significantly better clinical outcomes compared with CAF. The new measuring method provided high accuracy and unforeseen precision in the evaluation of treatment outcomes after surgical RC.

Abstract

AIM: The aim of this randomized clinical trial (RCT) was to introduce 3D digital measuring methods for evaluating the outcomes after surgical root coverage (RC) and to assess the clinical performance of the tunnel technique with subepithelial connective tissue graft (TUN) versus the coronally advanced flap (CAF) with enamel matrix derivative in the treatment of shallow localized gingival recession defects. MATERIAL AND METHODS: Twenty-four patients contributed a total of 47 Miller class I or II recessions for scientific evaluation. Clinical outcomes were evaluated at 6 and 12 months. Precise study models gained at baseline and follow-up examinations were optically scanned and virtually superimposed for digital evaluation of clinical outcome measures including percentage of RC and complete root coverage (CRC). Patient-centred outcomes were evaluated with questionnaires. Final aesthetic outcomes were assessed using the root coverage esthetic score (RES). RESULTS: At 12 months, RC was 98.4% for TUN-treated and 71.8% for CAF-treated defects (p = 0.0004). CRC was observed in 78.6% (TUN) and 21.4% (CAF) of the cases (p = 0.0070). Results for patient-centred outcomes were equivalent for both groups but evaluation of the final aesthetic outcomes using the RES revealed a significant difference (9.06 versus 6.92, p = 0.0034) in favour of TUN. CONCLUSIONS: TUN resulted in significantly better clinical outcomes compared with CAF. The new measuring method provided high accuracy and unforeseen precision in the evaluation of treatment outcomes after surgical RC.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic for Fixed and Removable Prosthodontics
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2014
Deposited On:29 Nov 2013 07:43
Last Modified:05 Apr 2016 17:12
Publisher:Wiley-Blackwell
ISSN:0303-6979
Publisher DOI:https://doi.org/10.1111/jcpe.12178
PubMed ID:24117676

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