Evaluation of coronally advanced flap with different positioned of de-epithelialized free gingival grafts for single gingival recessions

The clinical study aim to evaluate the clinical efficacy of de-epithelialized free gingival graft (De-epFGG) ( reversed) and De-epFGG (non reversed) on the treatment of single gingival recessions classified accordingly to Cario with coronally advanced flap (CAF). İn this study , the clinical results in localized gingival recession in terms of root surface closure, soft tissue volume and aesthetics paremeters were compared. The subjects were selected from the group of patients referred for hypersensitivity and esthetic compliance to the Clinic of Gazi University, Department of Periodontology. In this study 37 patients, aged between 18-65 years ( mean age 43,5 ± 12,17) were participated. The subjects who were having single RT1 and RT2 buccal gingival recessions ≥ 2 mm of depth at anterior area of the upper or lower jaw (central and lateral incisors, canine, first and second premolars) and associated with visible cementoenamel junction ( CEJ) were enrolled in the study. Patients who had single gingival recession were randomly allocated to the two groups which had De-epFGG ( reversed) in 18 patients and De-epFGG (non reversed) in 19 patients . In our study, the root closure results of the free gingival graft which de-epithelialized by intraorally was sutured as non reversed (epithelialized surface in the vestibule) and reversed (non-epithelialized surface in the vestibule) were evaluated. Clinical measurements including plaque index (PI), gingival index (GI), pocket depth (PD), bleeding on probing (BP), clinical attachment level (CAL), keratinized tissue width (KTW), recession depth (RD), recession width (RW) and gingival thickness (GT) were measured at baseline, 3 and 6 months after surgery . In this study, Root Coverage Esthetic Score (RES) and complete root covarage (CRC) rate were evaluated in both groups after 6 months .It was found a greater reduction in gingival recession in the De-epSDG (Reverse) group compared to the De-epSDG (non reversed) group, however this difference was not statistically significant. After 6 months Complete Root Coverage (CRC) in the De-epFGG (reverse) group (93,51±5,80 %) was higher than the De-epFGG (non reverse) group (78,54±19,56 %) and it was found that this difference was statistically significant (p<0,05). It was found that higher KTW values were observed in De-epSDG (non reversed) and (De-epFGG) ( reversed) groups at the end of 6th month compared to the baseline (p <0.01). Clinical and esthetic parameters of our study showed that, the reversed and non reversed surfaces of De-epSDG were applied in single gingival recessions with CAF surgical procedure, resulted in a succesful clinical outcome.