To Compare Two Commonly Used Soft Tissue Grafting Techniques to Achieve Coronal Flap Advancement and Root Coverage

Research data and daily clinical observations reveal that teeth with gingival recession and a lack of adequate keratinized tissue (KT) are more prone to persistent gingival inflammation, dentinal sensitivity, radicular (root) caries (tooth decay), faster periodontal attachment loss, and compromised plaque control. Soft tissue grating (by various techniques) aims at changing the quality, quantity and placement of the soft tissue around teeth by covering exposed root surfaces and creating or increasing the zone of keratinized mucosa (KM) surrounding the affected teeth. Both techniques tested have shown good clinical outcomes with regard to root coverage, but clinical reports of the VISTA technique and other similar techniques suggest that patients experience a decrease in site morbidity and discomfort post‐operatively. This study will compare two surgical incision designs used in conjunction with coronally advanced flap (CAF) and acellular dermal matrix (ADM) Specific aims for this project include the evaluation of: ‐ Percentage of root coverage at 6 and 12 months following grafting with VISTA and sulcular tunnel access with ADM ‐ KT width at 6 and 12 month following grafting with VISTA and sulcular tunnel access with ADM ‐ Change in tissue thickness of the grafted sites at 6 and 12 months ‐ Practitioner‐assessed esthetic outcomes using a standardized pink esthetic scale (PES) at 6 and 12 months postoperatively ‐ Patient‐assessed esthetic outcomes at 6 and 12 months post‐operatively ‐ Patient centered outcomes including pain, bleeding, swelling, change in daily activities at 1 week and 1 month postoperatively