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The effects of vertically coronally advanced flap and free gingival graft techniques on shallow vestibule: a randomized comparative prospective trial

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Abstract

Objectives

The present study aimed to compare the influence of vertically coronally advanced flap (V-CAF) and free gingival graft (FGG) techniques on shallow vestibule depth (VD).

Materials and methods

Parallel-arm randomized clinical trial was conducted on 38 sites treated with either FGG or V-CAF. Periodontal variables (VD, recession depth and width, probing depth, clinical attachment level, keratinized tissue height (KTH), and tissue thickness (TT)), clinician- and patient-based subjective variables were assessed.

Results

All periodontal variables showed significant improvements in both groups at all follow-up intervals compared to baseline (p < 0.05). Both groups increased VD compared to baseline. RC and CRC were similar after treatment for both techniques. FGG provided a greater increase in KTH (p < 0.001) and VD (VD1, p = 0.02 and VD2, p < 0.001) while V-CAF exhibited more TT gain (p = 0.002). Except overall tissue appearance that was better in V-CAF (p < 0.001), no inter-group significant difference existed in patient-based variables.

Conclusions

Both techniques were significantly effective in VD increasing. While both techniques were equally successful in RC, V-CAF provided higher TT gain and better tissue appearance. V-CAF can be chosen instead of FGG in the treatment of recessions with shallow VD.

Clinical relevance

It can be recommended to prefer V-CAF instead of FGG in the treatment of shallow vestibule.

Trial registration number

NCT05777811 (clinicaltrials.gov).

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Data availability

The data relevant to the study are available from the corresponding author upon request.

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Acknowledgements

The authors would like to thank Ayhan Parmaksiz in the Department of Biostatistics, Istanbul Health & Technology University, for performing the statistical analyses.

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Authors and Affiliations

  1. Department of Periodontology, Faculty of Dentistry, Hacettepe University, Sihhiye, 06100, Ankara, Turkey

    Hanife Merva Parlak, Murat Haktan Durmaz, Havanur Toz & H. Gencay Keceli

  2. Private Practice, İzmir, Turkey

    Birtan Tolga Yilmaz

  3. Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA

    Birtan Tolga Yilmaz

  4. Department of Dental Biomaterials, Institute of Health Science, Dokuz Eylul University, İzmir, Turkey

    Birtan Tolga Yilmaz

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  1. Hanife Merva Parlak
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Contributions

H.M.P., B.T.Y., M.H.D., and H.G.K. contributed to the study design. H.M.P. contributed to data collection. H.M.P., B.T.Y., and H.G.K. contributed to data interpretation. H.M.P., B.T.Y., and H.T. wrote the first draft of the manuscript. H.G.K. revised and refined the manuscript. All authors have read and approved the submitted manuscript.

Corresponding author

Correspondence to H. Gencay Keceli.

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Ethics approval

Ethical approval was obtained from the Clinical Research Ethics Committee of Hacettepe University (2020/18–01, (KA-20097)), and the trial adhered to the Helsinki Declaration of 1975, as revised in 2013.

Consent to participate

Informed consent was obtained from all individual participants included in this study.

Competing interests

The authors declare no competing interests.

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Parlak, H.M., Yilmaz, B.T., Durmaz, M.H. et al. The effects of vertically coronally advanced flap and free gingival graft techniques on shallow vestibule: a randomized comparative prospective trial. Clin Oral Invest 27, 7425–7436 (2023). https://doi.org/10.1007/s00784-023-05332-4

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