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 Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
36
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.
Cairo University
Cairo, AlManial, Egypt
RECRUITINGGingival recession depth
Time frame: From enrollment to the end of treatment at 1 year
Gingival recession depth lingual
Time frame: From enrollment to the end of treatment at 1 year
Clinical attachment level (CAL) buccal and lingual
Time frame: From enrollment to the end of treatment at 1 year
Periodontal probing depth (PPD) buccal and lingual
Time frame: From enrollment to the end of treatment at 1 year
Width of keratinized tissue (KTW)
Time frame: From enrollment to the end of treatment at 1 year
Papilla tip to contact point distance
Time frame: From enrollment to the end of treatment at 1 year
Mean root coverage
Time frame: 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.
Time frame: 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.
Time frame: From enrollment to the end of treatment at 1 year
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