Vertically Coronally Advanced Flap Versus Coronally Advanced Flap for Miller Class I Gingival Recession

Overview

This randomized controlled clinical trial aims to compare the clinical effectiveness of the Vertically Coronally Advanced Flap (VCAF) and the Coronally Advanced Flap (CAF), both combined with connective tissue graft (CTG) and enamel matrix derivative (EMD), for the treatment of Miller Class I gingival recession. Twenty-six Miller Class I gingival recession defects will be randomly assigned in a 1:1 ratio to either the VCAF + CTG + EMD group or the CAF + CTG + EMD group. Clinical outcomes, including mean root coverage, complete root coverage, recession depth, recession width, probing depth, clinical attachment level, keratinized tissue width, gingival thickness, vestibular depth, and esthetic outcomes, will be assessed at baseline and throughout a 6-month follow-up period. Three-dimensional digital models obtained from an intraoral scanner will also be used to evaluate soft tissue changes following treatment. The study is designed to determine whether the VCAF technique provides superior clinical and esthetic outcomes compared with the conventional CAF technique.

Gingival recession is a common mucogingival condition that may result in dentin hypersensitivity, root caries, plaque accumulation, and esthetic concerns. Coronally Advanced Flap (CAF) combined with connective tissue graft (CTG) is considered the gold standard for the treatment of localized gingival recession because of its predictable root coverage outcomes. However, coronal advancement of the flap may reduce vestibular depth, potentially affecting oral hygiene practices and long-term soft tissue stability. The Vertically Coronally Advanced Flap (VCAF) technique has been developed to facilitate coronal flap advancement while preserving vestibular depth. This study compares VCAF and conventional CAF, both combined with CTG and enamel matrix derivative (EMD), to determine whether VCAF can provide comparable or improved root coverage while minimizing changes in vestibular depth and achieving favorable esthetic outcomes. In addition to conventional clinical assessments, three-dimensional digital intraoral scans will be used to quantify soft tissue changes following surgery, providing a comprehensive evaluation of treatment outcomes.