Investigation On The Microcirculation Of The Modified Coronally Advanced Tunnel Technique After Root Coverage Procedure

Objectives: The application of autologous connective tissue graft (CTG) in combination with the modified coronally advanced tunnel technique (MCAT) is a standard method to treat multiple gingival recessions. However, the graft harvesting may increase patient morbidity and the duration of surgery as compared to surgical techniques using xenogenic matrices. The widely used xenogenic collagen matrix Mucograft has optimal tissue integration without inflammatory adverse reactions, but delays the revascularization of the wound bed according to a recent in vitro study. The aim of our study was to compare the effect of Mucograft and CTG on the microcirculation of MCAT.
Methods: In an exploratory study 8 patients (4 females and 4 males) received either Mucograft or CTG from the palate combined with MCAT. Clinical outcomes were evaluated after 6 months. Postoperative gingival microcirculation was followed up throughout 6 months by a Perimed Laser Speckle Contrast Analyzer. Wound fluid secretion was measured by Periotron 8000.
Results: Reduction of recession depth and width were comparable in the two groups, but the gain in keratinized tissue width at Mucograft treated sites was significantly less than in CTG. Interestingly, Mucograft treated sites showed significantly higher blood flow postoperatively, especially in male subjects. Overall, males had significantly more increase in blood flow. There were no differences in wound fluid secretion between graft types. Females had higher and more prolonged wound fluid secretion.
Conclusions: The microcirculation of the MCAT recovers quickly within 10 days. The recovery of graft bed circulation was not restrained by the application of Mucograft. Gender may have an effect on blood flow and inflammation following root coverage procedures, but this needs to be confirmed in further experiments.