Selective Versus Contiguous Connective Tissue Grafts in the Modified Tunnel Technique (MCATTs)

Evaluation of the Modified Coronally Advanced Tunnel Technique Associated With a Selective/Segmented Versus Contiguous Submerged Connective Tissue Graft for the Treatment of Multiple Gingival Recessions: Randomised Controlled Clinical Trial

The goal of this study is to evaluate how effective a gum grafting procedure is in treating gum recession that affects several teeth. Gum recession happens when the gum tissue pulls away from the tooth, exposing the roots. The study will look at how the treatment improves gum health, appearance, and function.

A total of 32 patients will take part in the study. All patients will be treated with a modified coronally advanced tunnel. For half of them of contiguous graft will be used, for the other half a segmented graft.

Data collected will include medical history, dental and aesthetic information, clinical measurements, and a digital scan of the mouth.

The study will include the following steps:

Before the procedure: You will have a clinical and X-ray examination to determine how much your gums have receded. A digital impression of your teeth will also be taken.

Surgical procedure: You will receive a gum graft to cover the exposed roots. This involves moving gum tissue, often taken from the roof of your mouth, to the affected areas.

After the procedure: You will have several follow-up visits over a few months to check your healing and the results of the treatment.

Study timeline:

The surgery will be done once. Follow-up visits will take place 1, 3, 6, and 12 months after the surgery. The total duration of the study is about 12 months.

Study Overview

• Status: Recruiting
• Conditions: Gum Recession
• Intervention / Treatment: Procedure: Selective/Segmented graft; Procedure: Continuous graft

• Study Type: Interventional
• Enrollment (Estimated): 32
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Belgium
  • Liège
    • Liège, Liège, Belgium, 4000
      • Recruiting
      • CHU de Liège
      • Contact: Zacharenia Zoi ZAFEIRIADOU, MsC; Phone Number: +32 4 323 54 27; Email: uperio@chuliege.be
• France
  • Paris, France, 75116
    • Not yet recruiting
    • 26K Center for clinical research
    • Contact: Sofia Aroca, PhD; Phone Number: 0033139733434; Email: 26kparis@26kparis.com

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• ASA I or ASA II
• Good periodontal health
• Able to undergo oral surgery
• Must be 18 years old and older
• No smoking
• At least two teeth in the same sector in the maxilla and the right and left mandible (except in the mandibular incisive sector), of which at least 2 are contiguous, with vestibular gingival recessions of type RT 1 of 1-5mm (Cairo et al. 2011)
• An identifiable or restorable cemento-enamel junction (CEJ), with or without the presence of a non-carious cervical lesion (Pini-Prato et al. 2010)
• Plaque index (O'Leary 1972) and bleeding index (Ainamo et al. 1975) scores of less than 20%
• Able to give informed consent and have signed the consent forms

Exclusion Criteria:

• Teeth showing recession associated with a carious lesion, restoration or cervical prosthesis involving CEJ
• Teeth with recession depth >5mm
• Molars with recessions will be treated but will not be taken into account for the measurements
• Teeth with recession that have already undergone periodontal surgery
• Presence of severe tooth malposition, rotation or significant version of the tooth
• Smoker and ex-smoker
• Patient suffering from a disease affecting the periodontium
• Patient with clinical signs of active periodontitis
• Known pregnancy in progress or breastfeeding
• Contraindication to surgery
• Conditions or circumstances which would prevent completion of study participation or interfere with analysis of study results, such as history of no-compliance or unreliability
• Patients deprived of their liberty or under legal protection

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Selective/Segmented graft; In this group a segmented CTG will be used	Procedure: Selective/Segmented graft; In this group a segmented CTG will be used
Active Comparator: Continuous graft; In this group a continuous CTG will be used	Procedure: Continuous graft; In this group a continuous CTG will be used

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Digital complete root coverage	defined as the presence/absence of complete coverage of the recession at the mid-buccal aspect. It will be evaluated by taking the CEJ as a reference line, at the different timepoints, analysed digitally using the digital impression	3, 6 and 12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Complete Root Coverage	defined as the presence/absence of complete coverage of the recession at the mid-buccal aspect. It will be evaluated by taking the CEJ as a reference line, at the different timepoints.	3, 6 and 12 months
Mean Root Coverage	defined as the percentage of root coverage in the mid-buccal aspect, taking baseline as a refer-ence. It equals to difference of the linear distance (in mm, using probe) between the mid-buccal point of the CEJ and the mid-buccal margin at baseline and different timepoints, divided by the distance between the mid buccal point of the CEJ and the mid buccal margin at baseline. The MRC will be measured as percentage (%).	3, 6 and 12 months
Keratinized Tissue Height	Defined as the linear height of keratinized tissue, measured between the mid-buccal gingival mar-gin of the treated tooth and the muco-gingival junction (in mm using a probe). It will be measured at baseline and at the different timepoints.	3, 6 and 12 months
Recession reduction	defined as the linear reduction in recession (in mm using a probe), at the mid buccal aspect, be-tween baseline and the different timepoints. It will be measured at the different timepoints.	3, 6 and 12 months
Dental hypersensitivity	Assessed by 10 s air spray applied to the buccal cervical area (yes/no).	3, 6 and 12 months
Root-coverage Esthetic Score	Evaluated at the different timepoints according to Cairo et al. (2009).	3, 6 and 12 months
Digital mean root coverage	Defined as the percentage of root coverage in the mid-buccal aspect, taking baseline as a refer-ence. Measured by dividing the mean surface (in mm²) of the root covered by the procedure by the mean surface (in mm²) of root exposed at baseline. Measured digitally at 3-6 months and 1 year after surgery. [(Initial Exposed Root Surface(mm2) - Post-operative exposed root surface(mm2)) / Initial Exposed Root Surface(mm2)] x 100%.	3, 6 and 12 months
Digital recession reduction	defined as the reduction in recession (in mm², measured digitally), at the mid-buccal aspect, be-tween baseline and the different timepoints. It will be measured at the different timepoints.	3, 6 and 12 months
Digital Gingival soft tissues profile	Defined as the change in gingival soft tissue thickness between baseline and the different timepoints, measured at the mid buccal aspect, between baseline and the different timepoints tak-ing CEJ as reference.	3, 6 and 12 months
Volumetric Changes	evaluated as 3D changes in the volume of gingival tissue between different timepoints, measured using the digital impression.	3, 6 and 12 months
Patient Reported Outcome Measures	Self-perceived pain: Reported on a 100mm VAS scale ranging from 0 (no pain at all) to 100 (worst pain possible). Number, nature and frequency of medication: Patients will be asked to report every take of medica-tion (substance, posology, and time of the day). Swelling: Reported on a 100 mm VAS scale ranging from 0 (no swelling at all) to 100 (worst swelling possible). T Bleeding: Reported on a 100 mm VAS scale ranging from 0 (no bleeding at all) to 100 (worst bleed-ing possible). Discomfort during surgery: Reported on a 100 mm VAS scale ranging from 0 (no discomfort at all) to 100 (a lot of discomfort). Self-perceived hypersensitivity Aesthetic outcome (self-evaluation): Reported on a 100 mm VAS scale ranging from 0 (no not satis-fied at all) to 100 (best outcome they could imagine). Report other adverse effects/ complications	1, 2, 3, 4, 5, 6, 7, 14 days and 3, 6, 12 months

Collaborators and Investigators

• Sponsor: Centre Hospitalier Universitaire de Liege
• Collaborators: 26K Center for Clinical Research

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2025
• Primary Completion (Estimated): September 1, 2028
• Study Completion (Estimated): September 1, 2028

Study Registration Dates

• First Submitted: December 14, 2025
• First Submitted That Met QC Criteria: March 3, 2026
• First Posted (Actual): March 5, 2026

Study Record Updates

• Last Update Posted (Actual): March 5, 2026
• Last Update Submitted That Met QC Criteria: March 3, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Gingival recession; Connective tissue graft; Tunnel technique; Gum recession; Recession treatment
• Additional Relevant MeSH Terms: Periodontal Atrophy; Periodontal Diseases; Mouth Diseases; Stomatognathic Diseases; Gingival Diseases; Gingival Recession
• Other Study ID Numbers: B7072025000052

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