The Study On The Comparison Of Tunnel Technique And Coronally Advanced Flap In The Treatment Of Gingival Recession

Objectives:Tunnel technique(TUN),is the clinician’s tools for the treatment of gingival recession and has been described to achieve good clinical and aesthetic results in recent years.However,the evidence on the efficacy of TUN in the literature is lacking,so this article systematically assesses the efficacy and long-term stability of TUN and CAF combined with CTG in the treatment of gingival recession.Methods:Databases including PubMed,Web of Science,Embase,Medline,CNKI were searched to collect randomized controlled trials(RCTs)of CAF+CTG compared to TUN+CTG in the treatment of Miller class Ⅰ or Ⅱ gingival recession,The retrieval time is from the self-built database to March 1st,2023.Results:A total of 8 RCTS were included in this study,with 305 patients(454 recession sites)participating.Among them,three are considered low risk,four are considered medium risk,and one is considered high risk.The primary risk factor is allocation concealing.The results of the meta-analysis revealed that:In terms of the long-term stability of mean root coverage(MRC)of main indicators,there was no significant difference between the CAF group and the TUN group in both short-term and long-term results,which were[MD:1.45,95%CI(-2.93,7.32),P=0.52],and[MD:-0.7,95%CI(-6.41,5.00),P=0.81].However,the CAF group outperformed the TUN group in the long term[MD:5.69,95%CI(0.87,10.05),P=0.02],and the results of complete root coverage(CRC)analysis were similar to those of MRC.In the short term,keratinized gingiva(KTW)in the TUN group grew was significantly faster than the CAF group[MD:0.38mm,95%CI(-0.67mm,-0.10mm),P=0.008].Long-term findings revealed no significant difference between the two groups[MD:-0.26mm,95%CI(-0.94mm,0.43mm),P=0.46].The TUN group’s secondary index root aesthetic score(RES)was statistically significantly higher than the CAF group’s[MD:0.62,95%CI(0.28,0.96),P=0.0003].Because there were few results included in the literature and the heterogeneity was too great,there was no significant difference in the postoperative VAS pain index score[MD:0.53,95%CI(-1.96,3.03),P=0.68].Conclusion:This study found that both CAF+CTG and TUN+CTG could achieve good root coverage in the treatment of gingival recession,with CAF outperforming TUN and both treatment achieving good long-term stability.TUN group had a higher score than the CAF group in the postoperative RES.Given the limitations of this study,future clinical trials with larger samples,higher quality and longer follow-up time are still needed to evaluate the efficacy of tunneling in gingival recession surgery.Objectives:Comparing the clinical efficacy and patient satisfaction of tunnel technique and modified coronally advanced flap plus connective tissue graft in the treatment of Miller Ⅰ/Ⅱ Gingival recession.Methods:Data of patients diagnosed with Miller Class Ⅰ/Ⅱ gingival recession and undergoing root surface covering from September 2019 to March 2023 were collected and divided into control group(CAF+CTG)and experimental group(TUN+CTG).Get probing depth,clinical attachment level,gingival recession depth,keratinized tissue width,surgery time,visual analogue score and root coverage esthetic score for each group of 11 patients both before and six months after surgery.Result:Before surgery,there are no statistical differences between any of the data groups(P>0.05).After a period of 6 months,mean root coverage for control and test group was 91±14%and 92±13%,respectively(P=0.72),root coverage esthetic score for TUN and CAF group was 9.73±0.63 and 8.68±1.42,respectively(P=0.002)surgery time for control and test group was 36.81±9.66 minute and 26.91±6.88 minute,respectively(P=0.03).Compared to the CAF group,the TUN group had a greater pain index(P<0.05).Conclusions:The TUN and CAF group could produce better clinical results and enhance the patient satisfaction in treatment of Miller Ⅰ/Ⅱ gingival recession following six-months surgery.While the TUN group’s operation took longer than the CAF group’s and had a higher postoperative pain index,the TUN group’s aesthetic score was higher than the CAF group’s across all comparative parameters.Other data showed no significant difference between the two groups.