Controlled Clinical Evaluation of the Subpedicle Connective Tissue Graft for the Coverage of Gingival Recession

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Abstract
The purpose of this study was to clinically evaluate the 1-year coverage of gingival recessions by a subpedicle connective tissue graft according to the original technique compared to untreated recessions by measuring probing sulcus depth (PSD), height of keratinized tissue (HKT), and mucogingival junction location changes. Paired gingival recessions were selected in 15 patients. In each patient, one recession was randomly assigned for treatment (test group) and the other recession was left untreated (control group) for 1 year. Surgery consisted of a connective tissue graft covered by a double papilla full thickness flap. Height of recession (HR), PSD, HKT, and cemento-enamel junction to mucogingival junction distance (CEJ-MGJ) were recorded with a calibrated probe before surgery and 1 year postoperatively. The control group showed no statistically significant differences in any of the parameters. In the test group, HR mean decreased significantly (P < 0.0006) from 3.66 mm to 1.09 mm, representing a mean root coverage of 70.5%. HKT mean increased significantly (P < 0.0006) from 1.60 mm to 4.30 mm, and PSD mean showed no statistical difference. CEJ-MGJ remained statistically unchanged. The subpedicle connective tissue graft may provide a good amount of root coverage and a substantial increase of keratinized tissue. Connective tissue grafted beneath the alveolar mucosa does not induce its transformation into keratinized gingival tissue.