Efficacy of different gingival graft de-epithelialization methods: A parallel-group randomized clinical trial

Area of Science:

• Periodontology
• Oral Surgery
• Regenerative Dentistry

Background:

• Gingival recession treatment often involves connective tissue grafts.
• The de-epithelialized connective tissue graft (DE-CTG) technique aims to enhance graft integration.
• Debate exists regarding the clinical impact of incomplete epithelial removal in DE-CTG.

Purpose of the Study:

• To compare the clinical effectiveness and de-epithelialization efficacy of intraoral (io) versus extraoral (eo) DE-CTG techniques.
• To evaluate potential complications associated with epithelial remnants from DE-CTG.

Main Methods:

• Forty patients with single gingival recession were treated with coronally advanced flap and either eo- or ioDE-CTG.
• Surgical chair-time, periodontal outcomes, and patient-based variables were recorded.
• Histological analyses of graft imprints assessed de-epithelialization efficacy.

Main Results:

• No significant differences in overall clinical or aesthetic outcomes were observed between eo- and ioDE-CTG groups.
• Surgical chair-time was significantly shorter for the ioDE-CTG group.
• The eoDE-CTG technique resulted in fewer epithelial remnants compared to ioDE-CTG.

Conclusions:

• Both eo- and ioDE-CTG techniques yield comparable clinical results for treating gingival recession.
• Intraoral DE-CTG is less effective at epithelial removal, but this did not lead to detected long-term complications.
• Both techniques are viable options for recession treatment.