Comparative Evaluation of Novel 3D Tunneling Technique Versus Modified Coronally Advanced Tunnel (MCAT) With Connective Tissue Graft in the Management of Multiple RT2 Gingival Recession

Comparative Evaluation of Novel 3D Tunneling Technique Versus Modified Coronally Advanced Tunnel (MCAT) With Connective Tissue Graft in the Management of Multiple RT2 Gingival Recession: A Randomized Controlled Trial

Defects associated with severe interdental hard and soft tissue loss are challenging to the periodontist, mainly due to the increased avascular surface and the reduced interproximal periosteal bed. Reports on the surgical techniques used to address recession type 2 or 3 defects mostly showed statistics on the mid-facial root coverage that yielded outcomes that do not encompass coverage of the interdental exposed root surface which highlights areas of controversy in their use for papilla reconstruction. Several case reports and clinical studies have shown encouraging results, but the long-term data are not available in the literature yet. The novel 3D tunneling (3DT) method achieved significant clinical improvement with long term stability in a recent case series. However, additional research is needed to validate 3DT for its routine clinical use. Moreover, the 3DT method achieved a decrease in the lingual recession depth which should be pointed out that the technique also addresses lingual recession.

Study Overview

• Status: Recruiting
• Conditions: Gingival Recession
• Intervention / Treatment: Procedure: Root coverage

• Study Type: Interventional
• Enrollment (Estimated): 36
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • AlManial
    • Cairo, AlManial, Egypt, 11562
      • Recruiting
      • Cairo University
      • Contact: Riham O Professor, PHD; Phone Number: +201001405748; Email: riham.omar@dentistry.cu.edu.eg
      • Contact: Omar A Ashour, PHD; Phone Number: +201115537575; Email: omarmahmoud@dentistry.cu.edu.eg

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Buccal and lingual multiple adjacent recession defects classified as Cairo et al RT2.
• Age ≥18 years
• Full mouth plaque index score less than 20% O'Leary et al. 1972
• Patients with healthy systemic condition
• Clinical indication and/or patient request for root coverage

Exclusion Criteria:

• Patients with systemically compromised health
• Periodontal surgical treatment during the previous 24 months in the involved site
• Pregnant or lactating mothers
• Smokers
• Non-compliant patients
• Restored teeth
• Non-carious cervical lesion

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
Active Comparator: Modified coronally advanced tunnel (MCAT)	Procedure: Root coverage; The novel 3D tunneling (3DT) method achieved significant clinical improvement with long term stability in a recent case series. However, additional research is needed to validate 3DT for its routine clinical use.
Experimental: novel 3D tunneling (3DT)	Procedure: Root coverage; The novel 3D tunneling (3DT) method achieved significant clinical improvement with long term stability in a recent case series. However, additional research is needed to validate 3DT for its routine clinical use.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Gingival recession depth	From enrollment to the end of treatment at 1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Gingival recession depth lingual		From enrollment to the end of treatment at 1 year
Clinical attachment level (CAL) buccal and lingual		From enrollment to the end of treatment at 1 year
Periodontal probing depth (PPD) buccal and lingual		From enrollment to the end of treatment at 1 year
Width of keratinized tissue (KTW)		From enrollment to the end of treatment at 1 year
Papilla tip to contact point distance		From enrollment to the end of treatment at 1 year
Mean root coverage		From enrollment to the end of treatment at 1 year
Root coverage esthetic score (RES)	The RES system evaluates five variables 1 year following surgery: GM, marginal tissue contour (MTC), soft tissue texture (STT), MGJ alignment, and gingival color (GC). GM. Zero points = failure of root coverage (gingival margin apical or equal to the baseline recession); 3 points = partial root coverage; 6 points = CRC. MTC. Zero points = irregular gingival margin (does not follow the CEJ); 1 point = proper marginal contour/scalloped gingival margin (follows the CEJ). STT. Zero points = scar formation and/or keloid-like appearance; 1 point = absence of scar or keloid formation. MGJ. Zero points = MGJ not aligned with the MGJ of adjacent teeth; 1 point = MGJ aligned with the MGJ of adjacent teeth. GC. Zero points = color of tissue varies from gingival color at adjacent teeth; 1 point = normal color and integration with the adjacent soft tissues. Thus, the ideal esthetic score is 10.	From enrollment to the end of treatment at 1 year
Post operative pain using Visual analogue scale (VAS)	Pain score will be reported by the patient directly through Visual Analogue Scale (VAS) score (between 0 and 10.0: no pain, 1: minimal pain, 5: moderate pain, 10: severe pain) will be recorded at day 3, day 7, and day 14.	From enrollment to the end of treatment at 1 year

Collaborators and Investigators

• Sponsor: Cairo University

Publications and helpful links

General Publications

• Kazarian E, Inozemtseva K, Lebedeva E. A Novel 3D Tunneling (3DT) Surgical Technique for the Treatment of Gingival Recessions with Reconstruction of the Deficient Interdental Papilla and Interproximal Attachment Regeneration: A Case Series. Int J Periodontics Restorative Dent. 2025 Jan 24;45(1):31-45. doi: 10.11607/prd.6960. PMID: 38198432.

Study record dates

Study Major Dates

• Study Start (Actual): May 10, 2025
• Primary Completion (Estimated): January 10, 2027
• Study Completion (Estimated): May 10, 2027

Study Registration Dates

• First Submitted: March 30, 2026
• First Submitted That Met QC Criteria: April 10, 2026
• First Posted (Actual): April 13, 2026

Study Record Updates

• Last Update Posted (Actual): April 13, 2026
• Last Update Submitted That Met QC Criteria: April 10, 2026
• Last Verified: April 1, 2026

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: P-E-R-3-3-2

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No