Gingival phenotype changes after different periodontal plastic surgical techniques: a single-masked randomized controlled clinical trial

ObjectivesAim of this clinical study was to evaluate the effects on gingival thickness of three surgical techniques for root coverage: the coronally advanced flap (CAF) alone, with a sub-epithelial connective tissue graft (SCTG) or with leukocyte- and platelet-rich fibrin (L-PRF) membranes.MethodsSixty patients with RT1 single maxillary gingival recession were treated with CAF + L-PRF (20 patients), CAF + SCTG (20 patients) or CAF alone (20 patients). At baseline and 6-month after treatment, gingival thickness (GT), keratinized tissue width (KT), gingival recession (GR), clinical attachment level (CAL), probing depth (PD), PROMs, and the aesthetic outcome were recorded.ResultsCAF + SCTG and CAF + L-PRF groups showed a significantly greater mean GT increase than CAF alone (0.31 +/- 0.10 mm) with no significant differences between CAF + SCTG (0.99 +/- 0.02 mm) and CAF + L-PRF (0.92 +/- 0.52 mm) groups (p = 0.55). CAF + SCTG was associated with a significantly greater KT gain (3.85 +/- 1.04 mm), while in CAF + L-PRF (2.03 +/- 0.53 mm) and CAF (1.50 +/- 0.69 mm) groups, KT was not significantly increased. Both GR and CAL showed a significant within groups' improvement, without among-groups differences. No significant among-groups difference for the aesthetic outcome but greater discomfort and pain-killer consumption in CAF + SCTG group was detected.ConclusionAll investigated surgical techniques produced significant GR reduction and CAL gain. GT was similarly augmented by CAF + L-PRF and CAF + SCTG techniques; however, the CAF + SCTG technique produced a more predictable KT and GT increase.

Automated summary

The objective of this clinical study was to evaluate the effects of three surgical techniques on gingival thickness for root coverage. The results showed that both CAF + SCTG and CAF + L-PRF groups had significantly greater gingival thickness increase compared to the CAF alone group. CAF + SCTG technique also resulted in a more significant increase in keratinized tissue width.