Clinical comparison of two surgical techniques in obtaining complete root coverage of single RT1 gingival recessions

Objectives: This study aimed to compare the efficacy of the full-thickness palatal graft technique (FTPGT) and the coronally advanced flap with subepithelial connective tissue graft (CAF + SCTG) in achieving complete root coverage (CRC) in single gingival recessions (GR). Methods: Forty healthy patients with a single RT1 GR were randomized into two groups: 20 treated with CAF + SCTG and 20 with FTPGT. Baseline and 12-month measurements of GR, keratinized tissue width (KTW), probing depth (PD), clinical attachment level (CAL), and gingival thickness (GT) were recorded. CRC percentage, root coverage percentage (RC%), Root Coverage Esthetic Score (RES), patient-reported outcomes (PROs), and palatal wound healing were evaluated. Results: At the 12-month evaluation, 19 patients in the FTPGT group achieved CRC compared to 12 in the CAF + SCTG group (p < 0.004). FTPGT showed significantly more GR reduction (0.7 mm ± 0.19), greater CAL gain (0.65 mm ± 0.20), increased GT (0.99 mm ± 0.27), p < 0.001, and KTW gain (2.95 mm ± 0.5), and a higher RC% (12.71 ± 3.82), p < 0.002. PROs did not significantly differ between treatments, nor did palatal healing parameters. CAF + SCTG showed superior RES scores compared to FTPGT (p < 0.0003). Conclusions: FTPGT is more effective than CAF + SCTG in achieving CRC and improving GT, KTW, CAL gain, and GR reduction, particularly in deep recessions. CAF + SCTG provides superior esthetic outcomes. PROs were comparable between the two techniques, but palatal healing was slower in the FTPGT group. Clinical relevance: FTPGT, especially in deep single recessions, could serve as an alternative to CAF + SCTG, as it is associated with greater CRC, greater GT and KTW. However, it is linked to slower healing of the palatal donor site. Clincaltrial.gov registration NCT04028037.