title: Comparative evaluation of recession coverage with sub-epithelial connective tissue graft using macrosurgical and microsurgical approaches: A randomized split mouth study.
abstract: OBJECTIVE
  The aim was to compare the recession coverage outcomes when done macrosurgically and microsurgically.
  
  
  BACKGROUND
  Increasing interest in esthetics and the related problems such as hypersensitivity and root caries have favored the development of many root coverage procedures. Recession coverage up to a certain extent has solved these problems, but these procedures need good maintenance after the surgery for long-term benefits. With increasing advances in the field of recession coverage, microscope has added another dimension in undertaking the surgical procedure.
  
  
  METHODS
  Thirty Miller's Class I and II recession were treated using the sub-epithelial connective tissue graft from the palate. In 15 sites, the graft was placed at the recipient site with unaided eye (Group A) and in other 15 sites the graft was placed using surgical microscope (Group B). Clinical evaluation was done at baseline, 12 weeks and 24 weeks postoperatively using plaque index, gingival index, vertical recession (VR), probing depth, clinical attachment level (CAL), width of attached gingiva, papilla height (PH) and width, malalignment index (MI) and esthetic appearance.
  
  
  METHODS
  Paired and unpaired Student's t-test along with Wilcoxon Z-test were used to analyze the results and probability of P < 0.05 were accepted to reject the null hypothesis. Pearson correlation was used to correlate two parameters such as VR and CAL and MI and VR.
  
  
  RESULTS
  Both the techniques demonstrated predictable mean root coverage (Group A 61.78% and Group B 67.58%) at 6 months postsurgery. CAL gain was slightly better in Group B patients when compared to Group A patients. A moderate positive correlation for Group A while a mild correlation in Group B was seen between the MI and VR.
  
  
  CONCLUSIONS
  The use of the microscope enhances the results, but obtaining an expertise in using needs a lot of practice. The periodontal healing by both techniques should be evaluated histologically.
authors.affiliation: Department of Periodontology and Oral Implantology, DAV(C) Dental College and Hospital, Yamuna Nagar, Haryana, India.
authors.forename: Uditi
authors.initials: U
authors.lastname: Jindal
authors.affiliation: Department of Periodontology and Oral Implantology, DAV(C) Dental College and Hospital, Yamuna Nagar, Haryana, India.
authors.forename: Nymphea
authors.initials: N
authors.lastname: Pandit
authors.affiliation: Department of Periodontology and Oral Implantology, DAV(C) Dental College and Hospital, Yamuna Nagar, Haryana, India.
authors.forename: Deepika
authors.initials: D
authors.lastname: Bali
authors.affiliation: Department of Periodontology and Oral Implantology, DAV(C) Dental College and Hospital, Yamuna Nagar, Haryana, India.
authors.forename: Rajvir
authors.initials: R
authors.lastname: Malik
authors.affiliation: Department of Periodontology and Oral Implantology, DAV(C) Dental College and Hospital, Yamuna Nagar, Haryana, India.
authors.forename: Shalini
authors.initials: S
authors.lastname: Gugnani
keywords: Microsurgery; mucogingival surgery; recession; sub-epithelial connective tissue graft