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Advisory Committee Chair

Maria L Geisinger

Advisory Committee Members

Ramzi Abou-Arraj

Nico Geurs

Maninder Kaur

Hussein Basma

Amjad Javed

Document Type

Thesis

Date of Award

2020

Degree Name by School

Master of Dentistry (MDent) School of Dentistry

Abstract

The objective of this study was to evaluate the clinical and patient centered outcomes obtained following soft tissue grafting utilizing vestibular incision subperiosteal tunneling access (VISTA) or standard tunneling access (STA) procedures with acellular dermal matrix (ADM) and coronal flap advancement to treat Miller class I and II recession defects on single rooted teeth. Nine patients and 29 recession defects were randomly divided into two groups (A: VISTA, B: STA) and were treated and evaluated for six months post-surgically. For all participants included in the study the average recession defects at baseline were 2.48±0.57mm and at the six-month visit the average recession measured 0.43±0.57mm (a difference of -2.02±0.78mm). For participants in group A and group B, respectively, there was no statistically significant difference in mean baseline recession (2.44±0.14mm and 2.41±0.14 mm) and at six months the average recession measurement was 0.40±0.2 mm and 0.47±0.15mm for each group, respectively. Both groups demonstrated a significantly significant reduction in recession and the difference in the residual recession defects between the two groups was 0.191±0.29mm (p-value 0.4608), which was not significant. The changes in the average tissue thickness at the gingival margin (TT1) and 4 mm apical to the gingival margin (TT2), the width of keratinized tissue, the amount of attached tissue and probing depths on the facial surfaces at three sites, mesio-facial, midfacial, and disto-facial (MF, F, DF), were recorded at baseline, three months and six months. At 1-week and 1-month post-surgical visits, patients completed a visual analog score (VAS) assessment form reviewing their perception of pain, bleeding, swelling and any changes to their regular activities imposed by the healing from the procedure [activity tolerance scale (ATS)]. At seven days post-surgically participants in group A overall reported less pain and less deviation from regular activities, while those in group B reported less swelling and bleeding; however, none of these differences was statistically significant. At the six-month visit blinded investigators measured the aforementioned clinical parameters and a pink esthetic score (PES) was recorded. The participants also completed a patient satisfaction survey related to their experience in the study at this visit.

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