Postoperative discomfort following inverted periosteal pedicle graft versus subepithelial connective tissue graft for treating gingival recession RT1 & RT2: a randomized clinical trial

TL;DR

This study compares two surgical techniques for treating gum recession and finds that the inverted periosteal pedicle graft offers similar results with higher patient satisfaction.

Contribution

The study introduces the inverted periosteal pedicle graft as a viable alternative to the traditional subepithelial connective tissue graft.

Findings

iPPG showed comparable root coverage to SCTG with no significant difference in postoperative discomfort.

iPPG resulted in significantly higher patient satisfaction compared to SCTG after six months.

Both techniques significantly reduced recession depth from baseline.

Abstract

Despite being the most predictable root coverage technique, coronally advanced flap with subepithelial connective tissue graft (CAF + SCTG) necessitates graft harvesting from a second surgical site; increasing patient’s post-operative discomfort. Besides, due to the promising regenerative capacity of the periosteum and omitting the need for a second surgical site, periosteal pedicle graft (PPG) is tested as an alternative technique. Eighteen RT1 and RT2 gingival recession defects were randomly assigned to receive either CAF + SCTG or inverted PPG (iPPG). Postoperative discomfort, recession depth, and patient’s satisfaction were assessed within 6-months of follow-up.

Patients in the iPPG group reported postoperative discomfort (VAS) of (2.28 ± 0.83) compared to (3.11 ± 1.17) in SCTG group; with no statistically significant difference. Clinically, the mean recession depth was significantly decreased from baseline in iPPG group (from 3.78 ± 0.67 to 0.56 ± 0.53) and in SCTG group (from 3.89 ± 0.78 to 0.33 ± 0.5). Lastly, iPPG showed significantly higher level of patients’ satisfaction compared to SCTG.

iPPG can be a promising alternative to SCTG for root coverage with significantly increased patient’s satisfaction after six months and comparable clinical root coverage parameters.

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