Impact of connective tissue graft thickness on surgical outcomes: A pilot randomized clinical trial

Abstract

The aim of this study was to compare thick versus thin connective tissue grafts (CTG) for the treatment of gingival recession, over a 3-month period. Forty-two CTG procedures were performed on single tooth Miller Class I or II recession defects at either premolar or anterior sites in 30 individuals. Procedures were randomized (1:1 ratio) to CTG thickness of 1 or 2 mm (parallel group design). Primary outcomes were the change in the width of the zone of keratinized tissue and the amount of root coverage achieved 3months postoperatively at the recipient site. Secondary outcomes included change in the thickness of keratinized tissue at 3months and patient-reported outcomes, such as pain, bleeding, and swelling at both the recipient and donor sites at 1week, 2weeks, 1month, and 3months. No significant differences were found between the two groups for any of the primary or secondary outcomes. Mean root coverage achieved was 2.1±0.2mm in the 1-mm thick group and 2.5±0.2mm in the 2-mm thick group (P=0.33). Keratinized tissue width was increased by 2.2±0.2mm in the 1-mm thick group and by 2.7±0.3mm in the 2-mm thick group (P=0.18). Keratinized tissue thickness was increased by 1.0±0.1mm and by 1.2±0.1mm in the 1- and 2-mm thick groups, respectively (P=0.09). Within the current study limitations, our results suggest that similar root coverage and increase in the width and thickness of keratinized tissue can be achieved at 3months whether a 1- or 2-mm thick CTG is used.