Comparing CAF and TCAF With Soft Tissue Grafting for Treating Multiple Recessions in the Maxilla.

Ghent University Hospital (UZ)

Status: Enrolling

Conditions: Gingival Recession Localized Moderate; Gingival Recession, Mucogingival Surgery; Gingival Recession Generalized Moderate; Gingival Recessions; Gingival Recession, Plastic Surgery; Gingival Recession, Localized; Gingival Recession, Generalized

Treatments: Procedure: tunneled coronally advanced flap with a connective tissue graft; Procedure: coronally advanced flap with connective tissue graft

Study type: Interventional

Funder types: Other

Identifiers

NCT07158528

ONZ-2025-0158

Details and patient eligibility

About

Multiple techniques can be used for recession coverage. The most common techniques are: tunnel technique (T), coronally advanced flap (CAF) or a combination of both (TCAF). Tunnel and coronally advanced flap are frequently used in clinical practice, whereas the combined technique is a relatively recently developed surgical approach.

This randomized controlled trial compares CAF and TCAF to determine which technique provides better root coverage for receding gums at multiple adjacent teeth in the upper jaw. The main question it aims to answer is:

- What is the average root coverage achieved with each technique in the short and long term? This may be clinically relevant because covering gum recession can reduce tooth sensitivity, improve aesthetics and make oral hygiene easier.

Researchers will compare the coronally advanced flap (CAF = the gum is detached and repositioned higher) with the tunneled coronally advanced flap (TCAF = the gum is undermined, only partially detached and repositioned higher). In both techniques, a small piece of tissue is removed from the palate, which is used to cover the recession. The purpose of the connective tissue graft under the flap/tunnel is to increase thickness and provide support.

Participants will:

• Undergo surgery (CAF or TCAF, randomly assigned) to cover recessions
• Attend regular check-ups for up to 10 years after surgery
• Keep a postoperative journal (recording medication use, pain levels, tooth sensitivity, etc.)

Enrollment: 34 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• At least 18 years of age
• Good oral hygiene
• Presence of multiple gingival recessions in the maxilla
• Good general health

Exclusion criteria

• Smoker
• Pregnant women (assessed at each visit; if the patient becomes pregnant during follow-up, radiographs will not be taken)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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34 participants in 2 patient groups

TCAF + CTG

Active Comparator group

Description:

Tunneled coronally advanced flap with a connective tissue graft.

Treatment:

Procedure: tunneled coronally advanced flap with a connective tissue graft

CAF + CTG

Active Comparator group

Description:

Coronally advanced flap with a connective tissue graft.

Treatment:

Procedure: coronally advanced flap with connective tissue graft