Conventional v/s Microsurgical Approach in the Management of Gingival Recession Using De – Epithelialized Gingival Graft - A Randomized Controlled Trial

Abstract

Abstract OBJECTIVE: The use of a surgical microscope in periodontal plastic surgeries enhances the visual perception and illuminates the surgical field leading to precise incisions and adaptation of the flap resulting in aesthetically acceptable root coverage. Hence, the aim of the study was to compare and evaluate the clinical outcome of conventional and microsurgical approaches in the management of isolated gingival recession using a de-epithelialized gingival graft. MATERIAL AND METHODS: 24 patients exhibiting either Miller Class I or II recession were treated using coronally advanced flap with de-epithelialized gingival graft. 12 patients were managed using conventional technique and other 12 patients under surgical microscope. Clinical parameters included gingival index, plaque index, probing depth, recession depth, width of keratinized gingiva, and gingival thickness were measured at baseline and 4 months post-operatively. Visual analog scale for pain was recorded on day 3, 5 and 7 and wound healing index was recorded on 3rd and 5th day. Root surface area covered was analysed using ImageJ software. RESULTS: Both the groups demonstrated clinically significant improvements in terms of clinical parameters from baseline. There was a statistically significant reduction in pain on the 3rd and 5th day in the microsurgical group compared to the conventional group. The microsurgical group showed a significant improvement in healing on 3rd day than the conventional group. CONCLUSION: Within the limits of this study, it can be concluded that the use of magnifying tools like surgical microscope along with microsurgical instruments and sutures aids in aesthetically accepted outcomes with less post-operative morbidity. CLINICAL RELEVANCE: Use of magnification tools aid in precise handling of the tissue and better healing. TRIAL REGISTRATION: Clinical Trials Registry – India, Identification number CTRI/2021/07/035251.