Treatment of multiple gingival recessions, using the modified coronally advanced tunnel technique and subepithelial connective tissue graft with or without 24% EDTA root conditioning: 3- and 5-year outcomes of a randomized clinical trial

BACKGROUND: Gingival recession (GR) represents a highly common mucogingival condition in the permanent dentition in the general population. OBJECTIVES: The aim of this randomized, split-mouth clinical trial was to assess the 3- and 5-year results of the treatment of multiple GRs through modified coronally advanced tunnel technique (MCAT) and subepithelial connective tissue graft (SCTG) with or without 24% ethylenediaminetetraacetic acid (EDTA) root conditioning. MATERIAL AND METHODS: Twenty patients with 142 GRs received both test and control treatment (72 test sites: MCAT+SCTG+EDTA, and 70 control sites: MCAT+SCTG). Two patients were lost to follow-up before the 3-year mark; therefore, a total of 125 GRs were analyzed in 18 subjects. The mean and complete root coverage (MRC, CRC), gain in the clinical attachment level (CAL), gain in keratinized tissue width (KTW), gain in gingival thickness (GT), the root esthetic coverage score (RES), and patient-reported outcome measures (PROMs) were evaluated. RESULTS: All parameters showed significant improvement in both groups as compared with baseline. There were no statistically significant differences between 3 and 5 years within the groups except for GT, or between the groups at either time point. In the test group, MRC was 95.8% at 3 years and 94.2% at 5 years, with CRC obtained in 87.3% and 84.1% of GRs, respectively. In the control group, MRC was 92.6% at 3 years and 90.6% at 5 years, and CRC was achieved in 82.3% and 80.7% of GRs, respectively. Both groups achieved high RES: 9.0 and 8.9 for the MCAT+SCTG+EDTA and MCAT+SCTG sites after 3 years, and 9.1 and 9.0 after 5 years, respectively. After 5 years, the mean gingival recession height (GRH) decreased from 2.3 ±1.0 mm to 0.2 ±0.5 mm in the test group, and from 2.5 ±1.1 mm to 0.2 ±0.5 mm in the control group. CONCLUSIONS: Root surface conditioning with 24% EDTA did not contribute to the outcomes of MCAT+SCTG - 3 and 5 years postoperatively. Thus, its application in clinical practice is not justified.