Evaluating the Efficacy of Subepithelial Connective Tissue Graft and Plasma-rich Fibrin using a Modified Tunnel Technique with V-Reverse Sutures for Gingival Recession: A Research Protocol

Introduction: Gingival Recession (GR) is the exposure of the root surface due to apical migration of the gingival tissue margin below the Cementoenamel Junction (CEJ). GR defects have been treated with a range of surgical techniques. Among the various treatments available for promoting root coverage, autogenous Subepithelial Connective Tissue Graft (SCTG)-based techniques are among the most effective and predictable. Need of the Study: Suturing the graft in the flap results in mobile and unstable anchorage. Thus, the V-reverse sutures technique has been introduced to stabilise the graft favours angiogenesis and repair. Despite the promising outcomes of these techniques, comparative data on the effectiveness of using V-reverse sutures in multiple recession defects are limited. The present study is required to evaluate the clinical efficacy and patient-centered outcomes of this novel suturing technique using SCTG and PRF, which may enhance treatment predictability and healing outcomes. Aim: The purpose of the present study is to compare the effectiveness of SCTG and PRF using the modified tunnel technique in combination with the V-reverse sutures technique for the treatment of multiple GRs defects in the anterior maxilla and mandible. Materials and Methods: A single-blinded randomised controlled trial will be performed from April 2025 to October 2025 at the Department of Periodontology, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research (DMIHER), Sawangi (Meghe), Wardha, Maharashtra, India. A total of 20 systemically healthy patients aged 18 to 60 years with multiple GRs on the labial or buccal surfaces of the teeth will be included and examined over six months. SCTG will be placed in Group A and PRF will be placed in Group B. A total of 10 patients will be randomly allocated to each group. Clinical parameters {recession depth, periodontal probing depth, width of keratinised gingiva, gingival thickness and Gingival Biotype (BG)} will be assessed at baseline and after six months. Each patient will be questioned at the last control visit about satisfaction level with the colour, contour of gums and shape of gums; dentinal hypersensitivity; root coverage; pain and discomforts during surgery; cost-effectiveness; and postoperative discomfort. An independent t-test will be used for comparative evaluation of the effectiveness of the two groups at a 5% level of significance (p=0.05).