Clinical and patient-centered outcomes of novel overlapping rotated double flap versus subepithelial connective tissue graft in RT1 gingival recession: a pilot study.

This pilot randomized study compared the clinical effectiveness and patient-reported outcomes of the novel Overlapping Rotated Double (NORD) flap with the Subepithelial Connective Tissue Graft (SCTG) for the management of single isolated RT1 gingival recession defects. Thirty-two systemically healthy adults were randomly assigned to either the NORD or SCTG group. Primary outcomes included reduction in recession depth, percentage of root coverage, and patient-reported measures, while secondary outcomes included gingival thickness, width of attached gingiva, probing depth, and clinical attachment level. The NORD technique utilized a rotated double-flap design using adjacent tissues, whereas the SCTG group was treated with a pouch-and-tunnel approach with connective tissue graft placement. Clinical parameters were recorded at 14-days, 1-month, and 6-months postoperatively. Data were analyzed using analysis of covariance (ANCOVA) with adjustment for baseline values, age, and gingival phenotype. Both procedures resulted in significant clinical improvement. Mean recession depth reduction was 1.66±0.18mm for NORD and 1.48±0.18mm for SCTG (p=0.516), with root coverage of 76.6% and 72.05%, respectively. Secondary clinical outcomes were comparable between groups; however, NORD demonstrated advantages in patient-reported outcomes, including lower postoperative pain, absence of donor-site morbidity, and shorter surgical duration, suggesting it may be a conservative and time-efficient alternative to SCTG.