title: Connective tissue graft and tunnel or trapezoidal flap for the treatment of single maxillary gingival recessions: a randomized clinical trial.
abstract: BACKGROUND
  Although ample evidence supports connective tissue graft (CTG) use for root coverage, there is need for research on recipient site preparation approaches. The purpose of this study was to compare the outcomes of trapezoidal coronally advanced flap (CAF) and coronally advanced tunnel flap (TUN) when used in conjunction with CTG.
  
  
  METHODS
  Forty-two patients presenting 42 single maxillary, Miller Class I and II, gingival recession defects were randomly assigned to receive either CAF + CTG (N = 21) or TUN + CTG (N = 21). Clinical, patient-centred, and aesthetic outcomes were assessed.
  
  
  RESULTS
  Six months postoperatively, both groups resulted in significant reduction in recession depth and increases in keratinized tissue thickness and width. CAF + CTG and TUN + CTG mean root coverage was 87.2 ± 27.1% and 77.4 ± 20.4% respectively (p = 0.02). Complete root coverage was achieved in 71.4% and 28.6% of defects treated with CAF + CTG and TUN + CTG respectively (p = 0.01). At 7 days postoperatively, TUN + CTG patients reported significantly less pain experience (p = 0.04). Both approaches reduced dentine hypersensitivity by approximately 85% (p < 0.05). Patient-based aesthetic evaluation indicated significant improvement for both groups. Although patient- and professional-based aesthetic assessments revealed no differences between groups, tissue texture was significantly better for TUN + CTG (p = 0.02).
  
  
  CONCLUSIONS
  For root coverage of single maxillary recession defects, CAF + CTG was more effective than TUN + CTG (ClinicalTrial.org-NCT02814279).
authors.affiliation: Department of Periodontology, College of Dentistry - FOSJC, UNESP - São Paulo State University, São Paulo, Brazil.
authors.forename: Mauro Pedrine
authors.identifier: http://orcid.org/0000-0001-9468-0729
authors.initials: MP
authors.lastname: Santamaria
authors.affiliation: Department of Periodontology, College of Dentistry - FOSJC, UNESP - São Paulo State University, São Paulo, Brazil.
authors.forename: Felipe Lucas da Silva
authors.initials: FLDS
authors.lastname: Neves
authors.affiliation: Department of Periodontology, College of Dentistry - FOSJC, UNESP - São Paulo State University, São Paulo, Brazil.
authors.forename: Camila Augusto
authors.initials: CA
authors.lastname: Silveira
authors.affiliation: Department of Restorative Dentistry, College of Dentistry - FOSJC, UNESP - São Paulo State University, São Paulo, Brazil.
authors.forename: Ingrid Fernandes
authors.initials: IF
authors.lastname: Mathias
authors.affiliation: Department of Periodontology, College of Dentistry - FOSJC, UNESP - São Paulo State University, São Paulo, Brazil.
authors.forename: Stephanie Botti
authors.initials: SB
authors.lastname: Fernandes-Dias
authors.affiliation: Department of Periodontology, College of Dentistry - FOSJC, UNESP - São Paulo State University, São Paulo, Brazil.
authors.forename: Maria Aparecida Neves
authors.initials: MAN
authors.lastname: Jardini
authors.affiliation: Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA.
authors.forename: Dimitris N
authors.initials: DN
authors.lastname: Tatakis
mesh_terms: D000328:Adult; D003238:Connective Tissue / Q000637:transplantation*; D004955:Esthetics, Dental; D005260:Female; D005889:Gingival Recession / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult
keywords: dental aesthetics; dentin sensitivity; gingival recession; maxilla; pain measurement; surgical flaps