Gingival Recession (GR) is a common finding among adults, regardless of the oral hygiene levels. When it is associated with esthetic impairment, dentin hypersensitivity, root caries, surgical treatment is indicated. Mid-buccal Gingival Recessions are an extremely prevalent condition and have root coverage potential through periodontal plastic surgery procedures. A flap thickness of \> 0.8 mm results in 100% root coverage, whereas a flap thickness of \< 0.8 mm results in partial root coverage in Coronally Advanced Flap (CAF)procedure. The present study aims to increase the gingival thickness by microneedling procedures to enhance root coverage by CAF procedures in thin gingival phenotype.
Gingival recession (GR) is defined as the migration of the marginal tissue toward the apical of the cementoenamel junction. It is one of the most common mucogingival deformities requiring surgical correction. The rationale for treating buccal recessions are mainly aesthetic concerns, and clinical situations where unfavourable contour of the gingival margin might be an obstacle for proper plaque control. GRs are of 3 types with reference to interdental clinical attachment loss as Recession Type (RT) RT1, RT2 and RT3. Mid-buccal GRs have root coverage potential through periodontal plastic surgery procedures. Coronally positioned flap (CAF) is a simple and predictable treatment of gingival recession defects. It has been observed that a flap thickness of \> 0.8 mm results in a covered root surface of 100%, whereas a flap thickness of \< 0.8 mm results in partial root coverage in CAF procedure. Microneedling (MN), creates microinjuries that result in minimal superficial bleedings and create a wound-healing cascade from which various growth factors are released. MN as opposed to Connective Tissue Grafts is a non-surgical approach to increase gingival thickness, that results in significant changes in the Gingival Thickness of individuals with thin gingival phenotype.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
36
Isolated RT1 gingival recession treated by microneedling followed by Coronally Advanced Flap procedures
Isolated RT1 gingival recession treated by Coronally Advanced Flap procedures alone.
post graduate institute of dental sciences (PGIDS)
Rohtak, Haryana, India
Recession Depth
recorded in mm with a periodontal probe from the cementoenamel junction to the crest of the gingival margin at mid labial region.
Time frame: 6 months
RECESSION WIDTH (RW)
recorded in mm with a periodontal probe from the mesial to distal gingival margin at the level of cementoenamel junction.
Time frame: 6 months
ROOT COVERAGE PERCENTAGE
calculated in % according to the formula Root Coverage percentage = Recession depth (preop-postop)\*100 Recession depth preoperative
Time frame: 6 months
Gingival thickness(GT)
GT is calculated in mm and measured with the help of No:15 endodontic spreaders with silicon disc as stopper was inserted perpendicularly at 1.5mm apical to gingival margin, till the hard tissue was felt. The depth of penetration was noted using digital calliper
Time frame: 6 months
CLINICAL ATTACHMENT LEVEL (CAL)
Clinical attachment level will be measured in mm using a periodontal probe as the distance between the cemento- enamel junction and the base of pocket. Measurements will be made at 3 sites of each tooth
Time frame: 6 months
Probing Pocket Depth (PPD)
Probing pocket depth will be measured as the distance from gingival margin to the base of pocket in mm. The probing depth measurements will be assessed using the Periodontal probe
Time frame: 6 months
Bleeding on Probing (BOP)
It will be measured by walking the periodontal probe at each site of each tooth and recorded as 0 or 1.
Time frame: 6 months
Plaque Index (PI)
For the scoring, a mouth mirror, an explorer and a light source will be used on air dried teeth and gingiva. 0=no plaque, 1= plaque present on explorer and not visible to naked eye, 2= moderate layer of plaque visible to naked eye, 3= abundant plaque along gingival margin. Lesser score, better outcome.
Time frame: 6 months
Gingival Index (GI
Gingival index (GI) will be used to assess severity of gingival inflammation. 0= no inflammation, 1= mild inflammation, no bleeding. 2= inflammation with delayed bleeding. 3= spontaneous bleeding. lower score, better outcome.
Time frame: 6 months
Keratinized Tissue Width (KTW)
Keratinized tissue width will be measured in mm with the help of UNC 15 probe with silicon stopper from the mucogingival junction to the free gingival margin and measured on vernier caliper
Time frame: 6 months
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