De-epithelialized gingival unit graft for gingival phenotype modification and root coverage: a randomized controlled trial.

OBJECTIVES

The aim was to compare the outcomes of gingival phenotype modification achieved using a de-epithelialized gingival unit graft (DUG) and a de-epithelialized gingival graft (DGG) in the treatment of single gingival recession defects with a coronally advanced flap (CAF).

MATERIALS AND

METHODS

Subjects with bilateral RT1 gingival recession defects were recruited. The sites were randomly assigned to either the DUG or DGG group. The assessments were performed using clinical, linear, and volumetric digital measurements, as well as patient-reported outcome measures. Gingival thickness and mean root coverage were measured as the primary outcome variables.

RESULTS

The study was completed with 15 patients and 30 gingival recession defects. At the 6-month follow-up, the change in gingival thickness (DUG: 2.39 ± 0.65 mm; DGG: 1.66 ± 0.50 mm) and digital linear dimension (DUG: 1.66 ± 0.47 mm; DGG: 1.13 ± 0.36 mm) were significantly greater in the DUG group than in the DGG group (p = 0.001 and p = 0.008, respectively). Mean and complete root coverage values were greater in the DUG group, though not significant (95% vs. 75% and 93.3% vs. 66.7%, respectively). Graft thickness was significantly greater in the DUG group (p = 0.027; 1.55 ± 0.50 mm and 1.10 ± 0.32 mm, respectively). No significant intergroup differences were observed in postoperative pain perception or bleeding.

CONCLUSIONS

DUG demonstrated better root coverage and phenotype modification results. However, the baseline imbalance in graft thickness remains a potential confounder, and the findings should be interpreted cautiously.

CLINICAL RELEVANCE: DUG may offer an alternative tissue for phenotype modification and root coverage in cases with limited soft tissue thickness in the recipient area.

TRIAL REGISTRATION: ClinicalTrials.gov (identification number NCT05923294). https://clinicaltrials.gov/study/NCT05923294?cond=NCT05923294&rank=1 Date of Submission: June 20th, 2023.