Thick free gingival and connective tissue autografts for root coverage

Area of Science:

• Periodontology
• Regenerative Dentistry

Background:

• Gingival recession defects expose root surfaces, leading to aesthetic concerns and potential hypersensitivity.
• Free gingival autografts (FGGs) and subepithelial connective tissue autografts (CTGs) are surgical techniques used for root coverage.

Purpose of the Study:

• To compare the predictability of root coverage between FGGs and CTGs for Miller Class I and II marginal tissue recession defects.
• To evaluate the efficacy of CTGs versus FGGs in achieving complete root coverage.

Main Methods:

• A randomized controlled trial involving 10 patients with paired Miller Class I/II recession defects.
• Surgical treatment with either FGG or CTG, with measurements taken presurgically and at 3 and 6 months postoperatively.
• Standardized measurements of soft tissue recession using a calibrated probe and reference stents.

Main Results:

• Subepithelial connective tissue grafts (CTGs) achieved significantly higher mean root coverage (78-80%) compared to free gingival grafts (FGGs) (43%) at 3 and 6 months (P < 0.03).
• Complete root coverage was observed in 5 out of 9 CTG sites versus only 1 out of 9 FGG sites.
• Both techniques significantly improved keratinized tissue width and probing attachment levels, with most gains occurring within the first three months.

Conclusions:

• Subepithelial connective tissue grafts (CTGs) provide more predictable and greater root coverage for Miller Class I and II recession defects than free gingival grafts (FGGs).
• Both surgical techniques effectively enhance keratinized tissue and improve periodontal support.