# 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.

## Key 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.