Digital workflow to assess gingival recession coverage independently of the cemento-enamel Junction: a prospective clinical study using the modified coronally advanced tunnel technique with porcine dermal matrix

The limited number of studies using digital workflows to measure soft tissue changes depend on the cemento-enamel junction (CEJ), which has been reported to be unreliable. Our primary objective was to apply an advanced digital assessment method, measuring independent from the CEJ to evaluate the modified coronally advanced tunnel technique (MCAT) with a porcine dermal matrix (PDM) for gingival recession coverage.

Patients with type RT1 and RT2 gingival recessions were treated with the MCAT and a PDM. Plaster casts (preoperative and 6 months postoperative) were digitalized. Subsequent stereolithography (STL)-files were imported and superimposed in the open-source software GOM Inspect for computer-based analysis. Recession depth, mean root and complete root coverage (mRC and cRC), mean recession reduction (mRR) and gingival thickness were evaluated. Statistical analysis was performed using mixed linear models.

A total of 82 teeth (19 patients) were included in the study. Healing was uneventful in all patients. The mean preoperative recession depth was 1.34 ± 0.92 mm. mRC was 65.06 ± 48.26%, cRC was 25.61%, mRR was 0.87 ± 0.83 mm, and gingival thickness gain was 0.33 ± 0.30 mm, with comparable results for RT1 and RT2. Neither tooth type nor type of jaw had any effect on the amount of root coverage.

The digital evaluation workflow employed offers an approach to evaluate gingival recession coverage outcomes independent of the CEJ. The PDM used in combination with the MCAT shows promising results for root coverage.