Combined Bilaminar Tunnel Technique in Treating Difficult Gingival Recessions
May 23, 2026 updated by: Choying Lin
Effectiveness of the Combined Bilaminar Tunnel Technique in Treating Anatomically Difficult Gingival Recessions: A Prospective Cohort Study
The goal of this clinical trial is to learn if the combined bilaminar tunnel technique works to treat anatomically difficult gingival recessions. It will also explore whether anatomical factors are associated with root coverage outcomes. The main questions it aims to answer are:
Does the combined bilaminar tunnel technique improve root coverage outcomes in patients with anatomically difficult gingival recessions? Are specific anatomical factors associated with root coverage outcomes after the combined bilaminar tunnel technique?
Participants will:
Receive root coverage surgery using the combined bilaminar tunnel technique Visit the clinic for follow-up evaluations after surgery Receive clinical measurements to assess gingival recession and root coverage outcomes Receive radiographic evaluation to assess anatomical characteristics, if clinically indicated or available
Study Overview
Status
Completed
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
12
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
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Taipei, Taiwan, 10507
- Chang Gung Memorial Hospital
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Orthodontic patients who were going to be treated with cTUN approach for soft tissue modification.
- Healthy periodontal condition or well controlled periodontitis with periodontal probing depth ≦ 3mm, and absence of bleeding on probing.
- Thin gingival phenotype, determined with visible metal shade[27]
- Intact clinical and pre-surgery radiographic data (CBCT) was available, and the patient followed the recommended supportive post-surgery treatment at least 6 month after the surgery.
- Informed consent had been obtained prior to the mucogingival surgery.
Exclusion Criteria:
- Uncontrolled systemic disease, such as hypertension, diabetes.
- Untreated periodontitis
- History of radiation therapy on head and neck regions.
- Heavy smokers (more than 0.5 pack per day).
- Patient with pregnancy or breastfeeding.
- History of mucogingival surgery performed on the same site.
- Patient who did not comply to the recommended supportive treatment was regarded as erratic complier.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Patients who received root coverage surgery with combined bilaminar tunnel technique
|
Participants will receive root coverage surgery using the combined bilaminar tunnel technique for the treatment of gingival recession.
The procedure initiates with a partial-thickness flap at the sites with the most severe recession with tunnelled coronally advanced flap(tCAF), extending from the coronal margin to the mucogingival junction (MGJ).
For adjacent teeth, intrasulcular incisions are made to prepare a full-thickness flap using a tunnel knife.
A de-epithelialized connective tissue graft is harvested and stabilized at the coronal portion of the recipient site to facilitate root coverage.
Simultaneously, a volume-stable collagen matrix (VSCM) is placed apically within the partial-thickness flap to fill bone concavities and reduce tissue retraction forces during healing.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
mean root coverage and complete root coverage rate
Time Frame: From enrollment to six month after receiving the treatment
|
Mean root coverage will be calculated as the percentage reduction in gingival recession depth from baseline to the 6 month after receiving the treatment.
Gingival recession depth will be measured as the distance from the cemento-enamel junction to the gingival margin.
|
From enrollment to six month after receiving the treatment
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Correlation Between Clinical and Anatomical Factors and Baseline Recession Depth
Time Frame: perioperative
|
The correlation between clinical and anatomical factors and baseline recession depth will be assessed.
Clinical and anatomical factors will include baseline keratinized tissue width, tooth angulation, depth of alveolar bone concavity, angulation of alveolar bone concavity, root prominence, buccal bone dehiscence, and buccal bone thickness.
Baseline keratinized tissue width and recession depth will be measured clinically in millimeters using a periodontal probe.
Tooth angulation and angulation of alveolar bone concavity will be measured in degrees on CBCT images.
Depth of alveolar bone concavity, root prominence, buccal bone dehiscence, and buccal bone thickness will be measured in millimeters on CBCT images.
The correlation will be evaluated using linear regression analysis.
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perioperative
|
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Correlation Between Clinical and Anatomical Factors and Mean Root Coverage After Treatment with the Combined Bilaminar Tunnel Technique
Time Frame: From baseline to 6 month after treatment.
|
The correlation between clinical and anatomical factors and mean root coverage after treatment will be assessed.
Clinical and anatomical factors will include baseline keratinized tissue width, tooth angulation, depth of alveolar bone concavity, angulation of alveolar bone concavity, root prominence, buccal bone dehiscence, and buccal bone thickness.
Baseline keratinized tissue width will be measured clinically in millimeters using a periodontal probe.
Tooth angulation and angulation of alveolar bone concavity will be measured in degrees on CBCT images.
Depth of alveolar bone concavity, root prominence, buccal bone dehiscence, and buccal bone thickness will be measured in millimeters on CBCT images.
Mean root coverage will be calculated as the percentage reduction in recession depth from baseline to 6 months after treatment.
The correlation will be evaluated using linear regression analysis.
|
From baseline to 6 month after treatment.
|
|
Association Between Clinical and Anatomical Factors and Complete Root Coverage After Treatment
Time Frame: From baseline to 6 month after treatment
|
The association between clinical and anatomical factors and complete root coverage after treatment will be assessed.
Clinical and anatomical factors will include baseline keratinized tissue width, tooth angulation, depth of alveolar bone concavity, angulation of alveolar bone concavity, root prominence, buccal bone dehiscence, and buccal bone thickness.
Baseline keratinized tissue width will be measured clinically in millimeters using a periodontal probe.
Tooth angulation and angulation of alveolar bone concavity will be measured in degrees on CBCT images.
Depth of alveolar bone concavity, root prominence, buccal bone dehiscence, and buccal bone thickness will be measured in millimeters on CBCT images.
Complete root coverage will be recorded as a binary outcome, defined as the presence or absence of complete coverage of the previously exposed root surface at 6 months after treatment.
The association will be evaluated using logistic regression analysis.
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From baseline to 6 month after treatment
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
April 27, 2022
Primary Completion (Actual)
February 26, 2024
Study Completion (Actual)
February 26, 2024
Study Registration Dates
First Submitted
May 18, 2026
First Submitted That Met QC Criteria
May 23, 2026
First Posted (Actual)
June 1, 2026
Study Record Updates
Last Update Posted (Actual)
June 1, 2026
Last Update Submitted That Met QC Criteria
May 23, 2026
Last Verified
May 1, 2026
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 202200265A3D001
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
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