This study aims to evaluate whether the method of root surface preparation influences surgical outcomes. It will assess whether manual root instrumentation can be replaced by a less invasive erythritol air-polishing technique.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
20
Root surface preparation performed using erythritol powder air-polishing (EMS AIRFLOW PLUS) prior to root coverage surgery with a modified tunnel technique and subepithelial connective tissue graft.
Mechanical root surface preparation performed using manual Gracey curettes before root coverage surgery with a modified tunnel technique and subepithelial connective tissue graft.
Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw, Warsaw
Warsaw, Mazowsze, Poland
RECRUITINGMean Root Coverage (MRC, %)
Mean root coverage (MRC), expressed as a percentage (%), assessed at 6 and 12 months post-surgery. MRC is calculated as (GR₀ - GR₆) / GR₀ × 100% and (GR₀ - GR₁₂) / GR₀ × 100%, respectively. Gingival recession (GR), measured in millimeters (mm) as the distance from the cemento-enamel junction (CEJ) to the gingival margin at the mid-buccal aspect of the tooth, is used solely as an input parameter for the calculation of MRC.
Time frame: 6 months and 12 months post-surgery
Gingival recession height (GRH, mm)
Distance from the cemento-enamel junction (CEJ) to the gingival margin measured at the mid-buccal aspect of the tooth.
Time frame: baseline, 6 months, and 12 months post-surgery
Gingival recession width (RW, mm)
Horizontal distance measured at the level of the cemento-enamel junction (CEJ) between the mesial and distal margins of the gingival recession.
Time frame: baseline, 6 months, and 12 months post-surgery
Clinical Attachment Level (CAL, mm)
Distance from the cemento-enamel junction (CEJ) to the bottom of the gingival sulcus.
Time frame: Baseline; 6 and 12 months post-surgery
Probing Pocket Depth (PPD, mm)
Distance from the gingival margin to the bottom of the gingival sulcus.
Time frame: baseline, 6 months, and 12 months post-surgery
Gingival Thickness (GT, mm)
Thickness of the gingiva measured 3 mm apical to the gingival margin at the mid-buccal aspect of the tooth.
Time frame: baseline, 6 months, and 12 months post-surgery
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Keratinized tissue width (KTW, mm)
Distance from the gingival margin to the mucogingival junction
Time frame: baseline, 6 months, and 12 months post-surgery
Complete Root Coverage (CRC, %)
% CRC = (number of teeth with CRC = 1 after treatment / total number of teeth with gingival recession at baseline) × 100. CRC = 1: postoperative GR ≤ 0 mm, indicating complete root coverage. CRC = 0: postoperative GR \> 0 mm, indicating partial or no root coverage.
Time frame: 6 months and 12 months post-surgery
Gingival Recession Reduction (GR red, mm)
Reduction in recession height at 6 months: GR₀ - GR₆ Reduction in recession height at 12 months: GR₀ - GR₁₂
Time frame: 6 months and 12 months post-surgery
Clinical Attachment Level Gain (CAL Gain, mm)
Clinical attachment level gain at 6 months = CAL₀ - CAL₆ Clinical attachment level gain at 12 months = CAL₀ - CAL₁₂
Time frame: 6 months and 12 months post-surgery
Keratinized Tissue Width Gain (KTW Gain, mm)
Increase in keratinized tissue width at 6 months: KTW₆ - KTW₀ Increase in keratinized tissue width at 12 months: KTW₁₂ - KTW₀
Time frame: 6 months and 12 months post-surgery
Tooth Sensitivity (SEN, Schiff score)
Clinician-assessed tooth sensitivity evaluated using the Schiff Cold Air Sensitivity Scale. Air will be delivered using a standard air syringe of the dental unit, positioned approximately 1 cm from the tooth surface for 5 seconds, at a working temperature of 23 °C (±4 °C), and directed at the exposed buccal surface of the tooth with gingival recession. Patient response to the air stimulus will be assessed by the clinician using the Schiff Cold Air Sensitivity Scale as follows: 0 = No response to the air stimulus 1. = Response to the air stimulus, but no request to discontinue the stimulus 2. = Response to the air stimulus, with a request to discontinue the stimulus and/or turning away from the stimulus 3. = Painful response to the air stimulus, with a request to discontinue the stimulus
Time frame: Assessed on the day of surgery before administration of anesthesia, and subsequently at 6 and 12 months after surgery.
Root Esthetic Score (RES, score)
Root Esthetic Score (RES), expressed as a composite score ranging from 0 to 10 points. The RES is a clinician-assessed composite esthetic outcome comprising the following five components: 1. Gingival Margin (GM): failure of root coverage (0 points), partial root coverage (3 points), complete root coverage (6 points); 2. Marginal Tissue Contour (MTC): irregular gingival margin not following the cemento-enamel junction (CEJ) (0 points), scalloped gingival contour following the CEJ (1 point); 3. Soft Tissue Texture (STT): presence of scar (0 points), absence of scars (1 point); 4. Mucogingival Junction (MGJ): MGJ not aligned with the MGJ of adjacent teeth (0 points), MGJ aligned with the MGJ of adjacent teeth (1 point); 5. Gingival Color (GC): color mismatch with adjacent teeth (0 points), color matching adjacent teeth (1 point). The total RES score is calculated as the sum of all component scores, with higher scores indicating a better esthetic outcome.
Time frame: 6 and 12 months after surgery
Discomfort during the procedure (VAS, 0-10)
Patient-reported discomfort during the procedure assessed using the Visual Analogue Scale (VAS; 0 = no discomfort, 10 = extreme discomfort).
Time frame: Immediately after completion of the procedure
Pain intensity (VAS scale, 0-10)
Patient-reported pain intensity assessed using the Visual Analogue Scale (VAS; 0 = no pain, 10 = maximum pain).
Time frame: 1, 2, 4, 7, 14 days after procedure
Postoperative swelling (VAS scale, 0-10)
Patient-reported swelling assessed using the Visual Analogue Scale (VAS; 0 = none, 10 = maximum).
Time frame: 1, 2, 4, 7, 14 days after procedure
Tooth sensitivity (VAS, 0-10)
Patient-reported tooth sensitivity assessed using the Visual Analogue Scale (VAS; 0 = none, 10 = maximum).
Time frame: 1, 2, 4, 7, and 14 days post-procedure
Gingival color (VAS, 0-10)
Patient-reported gingival color assessed using the Visual Analogue Scale (VAS; 0 = very poor, 10 = excellent).
Time frame: 6 and 12 months post-surgery
Gingival shape (VAS 0-10)
Patient-reported gingival shape assessed using a single Visual Analogue Scale (VAS; 0 = very poor, 10 = excellent)
Time frame: 6 and 12 months post-surgery
Tooth appearance (VAS, 0-10)
Patient-reported tooth appearance assessed using the Visual Analogue Scale (VAS; 0 = very poor, 10 = excellent).
Time frame: 6 and 12 months post-surgery