Mucogingival treatment of class III gingival recessions with apical buccal access flap: randomized clinical trial
Miller Class III multiple gingival recessions
The test group will be treated with apical buccal access approach and connective tissue graft Control group will be treated with tunnel approach and connective tissue graft The intervention will we realized in a single session and the follow-up will be 12 months after the surgical procedure. Randomization will be carried out by means of 5 blocks by a sequence generated by the computer. Randomization: The randomization will be carried out prior to the procedure by the statistician (EGT) but without the operator (AOV) knowing the technique that he will have to use until the moment of the first incision. Assignment to the test or control group is done using a block-based computer algorithm after the inclusion of the patient and prior to the surgical intervention. The randomization treatment assignment is disclosed at the time of the surgical procedure. Each patient included in the study has the same probabilities as the others of being assigned to the test or control group. Surgical procedure: On day 0 the first surgical procedure will be performed, which will include the following phases: The stopwatch is activated to measure the intervention time Local anesthesia Depending on the randomization: incision to the bottom of the vestibule in a semilunar shape / preparation of the beds that will receive the graft by tunneling and connecting all the recessions through the tunnel without making incisions Elevation of a full thickness flap to create a vascular bed for the graft anesthetize the posterior palatal area (distal to the premolars) and take a graft that is the length and width of the treated area and is between 1-2mm thick The stabilization of the grafts will be carried out by means of a dento-anchored suture to the contact points of the previously splinted teeth to be able to suture this way. Photographic documentation before the incision, after preparation of the bed, after obtaining the graft and after suturing. Record of the duration of surgery. Recording th
1. Informed consent after detailed information 2. Adults at least 18 years of age 3. Patients with multiple recessions (≥2 teeth) class III Miller with shallow vestibulum depth and keratinized mucosa 4. Non-molar teeth 5. Upper and lower jaw 6. Healthy or periodontally treated patients 7. Systematically healthy or with fully controlled or stabilized diseases 8. A medical report will be requested to confirm the stabilization of the specific disease 9. General plaque control (FMPS) ≤25%
1. Pregnant or breastfeeding patients 2. Uncontrolled periodontal disease 3. Patients treated with any medication that affects gingival conditions such as causing hyperplasia 4. Alcohol and/or drug abuse 5. Not signing informed consent 6. Molar area