Gingival Unit Graft Versus Free Gingival Graft: 18-Month Digital Color Analysis

July 15, 2026 updated by: Sanubar Shakiliyeva, Bezmialem Vakif University

Clinical Outcomes and Digital Color Stability of Gingival Unit Graft Versus Free Gingival Graft: An 18-Month Comparative Digital Photographic Color Analysis Study

The purpose of this retrospective clinical study is to compare the long-term aesthetic integration and clinical outcomes of two periodontal plastic surgery techniques: Gingival Unit Grafting (GUG) and Free Gingival Grafting (FGG). The study evaluates the effectiveness of these procedures in increasing keratinized tissue width and assesses the color integration of the grafted tissues with the surrounding gingiva over an 18-month follow-up period using objective digital color analysis based on CIE Lab and RGB parameters.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This single-center retrospective study included patients treated with either Gingival Unit Grafts (GUG) or Free Gingival Grafts (FGG) for the management of Cairo Type 2 and Type 3 gingival recessions between March 2022 and December 2022. Clinical and photographic records obtained at baseline and during follow-up visits up to 18 months were retrospectively analyzed. The primary outcome was the evaluation of color integration of the grafted tissues using objective digital color analysis based on CIE Lab and RGB parameters. Secondary outcomes included changes in keratinized tissue width. The aim of the study was to compare the long-term aesthetic integration and clinical performance of GUG and FGG and to determine which technique provides superior color matching with the surrounding tissues.

Study Type

Observational

Enrollment (Actual)

40

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

  • Turkey (Türkiye)
    • Fatih
      • Istanbul, Fatih, Turkey (Türkiye), 34093
        • Bezmialem Vakif University, Faculty of Dentistry

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study population consists of adult patients seeking treatment for localized gingival recessions on mandibular incisors at a university faculty of dentistry.

Description

Inclusion Criteria:

  • Systemically healthy individuals aged between 18 and 65 years
  • No systemic diseases contraindicating periodontal surgery
  • Not taking medications known to exert adverse effects on periodontal tissues
  • Presenting with Cairo Type 2 (RT2) or Type 3 (RT3) localized gingival recessions on mandibular incisors
  • Presence of ≤1 mm of attached gingiva resulting in difficulty maintaining plaque control
  • Full-mouth plaque and gingival index scores ≤1
  • Bleeding on probing (BOP) <10%
  • No history of prior soft tissue surgery in the designated area

Exclusion Criteria:

  • Individuals who are pregnant or lactating.
  • Presenting with gingival recession or prosthetic restorations at the donor site (maxillary premolar palatal region).
  • Cases demonstrating caries, abrasions, or restorations on the root surfaces of the related teeth.
  • Individuals with known allergies to dental impression materials.
  • Periodontal pocket depth greater than 3 mm.
  • Tooth malposition.
  • Endodontic complications.

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

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Gingival Unit Graft (GUG) Group
Patients who underwent periodontal plastic surgery using Gingival Unit Grafts for keratinized tissue gain
Procedure: Gingival Unit Grafting
Harvesting a gingival unit graft and transplanting it to the recipient area to increase keratinized tissue width and assess long-term aesthetic integration.
Conventional Free Gingival Graft (FGG) Group
Patients who underwent periodontal plastic surgery using Conventional Free Gingival Grafts for keratinized tissue gain
Procedure: Conventional Free Gingival Grafting
Harvesting a conventional free gingival graft and transplanting it to the recipient area to increase keratinized tissue width and serve as a control group for aesthetic integration.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Aesthetic Integration (Color Evaluation)
Time Frame: Baseline and 18 months post-surgery
Objective assessment of color integration between the grafted tissue and the surrounding gingiva using digital color analysis. Color parameters were evaluated based on the CIE Lab* color space system and RGB color channels obtained from standardized clinical photographs. The degree of color matching between grafted and adjacent tissues was assessed over the follow-up period.
Baseline and 18 months post-surgery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Keratinized Tissue Width (KTW)
Time Frame: Baseline and 18 months post-surgery
The clinical measurement of the width of keratinized tissue in millimeters, evaluated from the gingival margin to the mucogingival junction using a standard periodontal probe to determine the amount of tissue gain.
Baseline and 18 months post-surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Bezmialem Vakif University

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)

March 1, 2022

Primary Completion (Actual)

June 30, 2024

Study Completion (Actual)

December 31, 2024

Study Registration Dates

First Submitted

July 11, 2026

First Submitted That Met QC Criteria

July 11, 2026

First Posted (Actual)

July 15, 2026

Study Record Updates

Last Update Posted (Actual)

July 16, 2026

Last Update Submitted That Met QC Criteria

July 15, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • No: 2024/304

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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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