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Multiple Recessions Coverage Using the Modified Tunnel Technique and Connective Tissue Graft with or Without
Bartłomiej Górski1, Izabela Maria Skierska1, Andrea Gelemanović2
1Department of Periodontal and Oral Mucosa Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland.
This study found that cross-linked hyaluronic acid (HA) combined with modified coronally advanced tunnel (MCAT) and subepithelial connective tissue graft (SCTG) provided comparable 2-year root coverage outcomes for multiple gingival recessions (GRs) versus MCAT + SCTG alone. While HA improved soft tissue texture, overall clinical results were similar between groups.
Area of Science:
- Periodontology
- Regenerative Dentistry
- Biomaterials Science
Background:
- Gingival recession (GR) affects numerous patients, necessitating effective root coverage procedures.
- Biologics, including hyaluronic acid (HA), are explored to enhance outcomes in periodontal regenerative therapies.
- The modified coronally advanced tunnel (MCAT) technique combined with subepithelial connective tissue graft (SCTG) is a standard surgical approach.
Purpose of the Study:
- To evaluate the 2-year clinical outcomes of root coverage for multiple gingival recessions using MCAT + SCTG with or without adjunctive cross-linked HA.
- To compare the stability and efficacy of root coverage between the test (MCAT + SCTG + HA) and control (MCAT + SCTG) groups over 24 months.
Main Methods:
- A split-mouth design was employed, randomizing 266 gingival recessions into test and control groups.
- Surgical procedures involved MCAT and SCTG, with the test group receiving additional cross-linked HA.
- Clinical outcomes, including root coverage, gingival recession height, clinical attachment level, gingival thickness, and root esthetic score, were assessed over 24 months.
Main Results:
- Both groups achieved high rates of complete root coverage at 2 years (87.02% test vs. 91.90% control).
- Mean root coverage was comparable between groups (81.37% test vs. 84.63% control).
- Adjunctive HA significantly improved soft tissue texture, though overall clinical outcomes and esthetic scores showed no significant inter-group differences.
Conclusions:
- Treatment of multiple gingival recessions with MCAT + SCTG, with or without adjunctive HA, yields comparable and stable 2-year clinical outcomes.
- The addition of cross-linked HA may offer benefits in soft tissue texture but does not significantly alter the primary root coverage efficacy.
- Both treatment modalities provide predictable and maintainable results for root coverage procedures over 24 months.
