Clinical Evaluation of the Modified Laterally Stretched Technique (RT2) Gingival Recession vs Tunneling With CT Grafting

Clinical Evaluation of the Modified Laterally Stretched Technique in the Gingival Recession Sites of the Lower Anterior Teeth (RT2) vs Tunneling With Connective Tissue Grafting in Both Techniques: A Randomized Clinical Trial

Regression analysis in a recent systematic review showed significantly greater mRC and CRC values when modifications are done to the TUN procedure to achieve more coronal advancement of the flap, coronal advancement also helps in covering the underlying graft for better recession coverage outcomes (Tavelli et al., 2018), limited data is present on the possible influence of a covered or partially uncovered graft. However, it has been suggested that minimal exposure of the CTG may aid not only in achieving CRC but also a harmonious gingival margin (John et al., 2015; Rasperini et al., 2011).

Study Overview

• Status: Active, not recruiting
• Conditions: Gingival Recession
• Intervention / Treatment: Procedure: Modified laterally stretched technique with a connective tissue graft.

• Study Type: Interventional
• Enrollment (Actual): 26
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Cairo, Egypt
    • Cairo University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

• Single or multiple RT2 gingival recession site/sites in the lower anterior teeth.
• Age >/= 18 years.
• Patients with healthy or treated periodontal conditions.
• Patients willing to participate in the study.
• Absence of uncontrolled medical conditions.
• Full mouth plaque score </= 20% (O'Leary 1972).
• Full mouth bleeding score <20% (Ainamo and Bay 1975).
• Patients with aesthetic concerns.

Exclusion Criteria:

• Pregnant or lactating females.
• deep recession sites more than 5 mm
• Tobacco smoking.
• Uncontrolled medical conditions.
• Uncooperative patients or unable to complete the study.
• Patients treated with any medication known to cause gingival hyperplasia.
• No occlusal interferences.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Modified laterally stretched technique with a connective tissue graft.; After the administration of local anesthesia, root planing of the exposed root surfaces will be performed by means of hand instruments. A partial thickness envelope is performed with tunneling instruments involving one or two teeth adjacent to the tooth, in case of a very thin biotype a complete thickness envelope could be done. Two horizontal incisions are done at the base of the papillae of the deepest recession site, allowing to place the graft in a more coronal position and improving access and visibility.	Procedure: Modified laterally stretched technique with a connective tissue graft.; Modified laterally stretched technique with a connective tissue graft.
Active Comparator: Tunneling technique with connective tissue graft.; Immediately before surgery, contact point composite stops were placed to prevent the collapse of the suspended sutures in the inter-proximal spaces.• The entire gingival papillary complex will be moved coronally using a suspended suture anchored in the lingual gingiva (Aroca et al., 2010, 2013; Azzi et al, 2002, zuhr et al.,2009).	Procedure: Modified laterally stretched technique with a connective tissue graft.; Modified laterally stretched technique with a connective tissue graft.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Recession depth reduction.	Measured as the difference between the recession gingival depth at different follow up intervals and the baseline.	1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean root coverage	(Preoperative vertical recession - Postoperative vertical recession/preoperative vertical recession) x 100	1 year
Recession depth	Measured as the distance between the free gingival margin and the cemento-enamel junction .	1 year
Recession width	Measured as the distance between the between the mesial gingival margin and distal gingival margin	1 year
Soft tissue thickness	The measurement of Gingival tissue thickness is performed 2 mm apical from the gingival margin.	1 year
Keratinized tissue width	Measured as the distance between the gingival margin and the muco-gingival junction.	1 year
Esthetics (RES) score	A system used to evaluate five variables 6 months gingival margin (GM), marginal tissue contour (MTC), soft tissue texture (STT), MGJ alignment, and gingival color (GC).	1 year
patient satisfaction	A 3-item questionnaire is asked, and the patients shall use a 7-point answer scale. The answers were given on a 7-point scale ranging from 1 'not at all'' to 7 ''very likely''.	1 year

Collaborators and Investigators

• Sponsor: Cairo University

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2023
• Primary Completion (Estimated): October 1, 2025
• Study Completion (Estimated): November 1, 2025

Study Registration Dates

• First Submitted: September 12, 2023
• First Submitted That Met QC Criteria: September 18, 2023
• First Posted (Actual): September 21, 2023

Study Record Updates

• Last Update Posted (Estimated): October 2, 2025
• Last Update Submitted That Met QC Criteria: October 1, 2025
• Last Verified: October 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Periodontal Atrophy; Periodontal Diseases; Mouth Diseases; Stomatognathic Diseases; Gingival Diseases; Gingival Recession
• Other Study ID Numbers: 21021992

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No