Coronally advanced flap with connective tissue graft with or without epithelial collar in the treatment of localized gingival recession and increasing width of Keratinized gingiva- A comparative study

Regarding to the prevalence of gingival recession, esthetic and sensitivity problems of denuded roots, a variety of surgical techniques have been used to cover recession type defects. This sequential matched randomized double blind clinical trial was designed to compare the clinical outcome following treatment of localized gingival recession by subepithelial connective tissue graft (SeCTG) with and without epithelial collar. Methods & Materials: Nine consecutively patients with bilateral 24 Miller class I gingival recession in non - molar teeth, were participated in this study. The surgical areas were randomly selected as split mouth and were treated by SeCTG with or without epithelial collar. Clinical measurements including recession height (RH), recession width (RW), probing depth (PD), keratinized gingiva (KG), and clinical attachment level (CAL) were measured at baseline and 3 months post operatively by means of Williams probe, caliper and stent. Changes in these clinical parameters were calculated in and between groups and analyzed statistically with paired T test. Both treatments resulted in a significant decrease in RH (1.88± 0.93 mm, P<0.000 in SeCTG with collar epithelium 1.54±1.11 mm, P<0.001 in SeCTG without collar epithelium) and RW (1.62±1.38 mm, P<0.002 in SeCTG with collar epithelium 1.22±1.62 mm, P<0.024 in SeCTG without collar epithelium). The mean changes in RH, RW, KG, CAL in each group to baseline were significant. However, the amount of these variables were not significant between the two groups. The subepithelial connective tissue graft with epithelial collar offers a more convenient approach for handling and suturing as a root coverage procedure and increasing width of keratinized gingiva in Miller class I recession defects specially in fixed and removable partial dentures for abutment teeth.