Can Modified Coronally Advanced Tunnel be an Alternative in Gingival Phenotype Modification?

GT, measured at the midpoint location between the gingival margin and mucogingival junction, using an endodontic spreader (#25 endodontic spreader, 25 mm; D-perfect, Shenzhen, China).

GT, measured at the mid-point location between the gingival margin and mucogingival junction, using an endodontic spreader (#25 endodontic spreader, 25 mm; D-perfect, Shenzhen, China).

GT, measured at the mid-point location between the gingival margin and mucogingival junction, using an endodontic spreader (#25 endodontic spreader, 25 mm; D-perfect, Shenzhen, China).

GT, measured at the mid-point location between the gingival margin and mucogingival junction, using an endodontic spreader (#25 endodontic spreader, 25 mm; D-perfect, Shenzhen, China).

KTH, measured from gingival margin to the mucogingival junction (MGJ).

KTH, measured from gingival margin to the mucogingival junction (MGJ).

KTH, measured from gingival margin to the mucogingival junction (MGJ).

KTH, measured from gingival margin to the mucogingival junction (MGJ).

RD, measured from the cemento-enamel junction (CEJ) to the most apical extension of the gingival margin.

RD, measured from the cemento-enamel junction (CEJ) to the most apical extension of the gingival margin.

RD, measured from the cemento-enamel junction (CEJ) to the most apical extension of the gingival margin.

RD, measured from the cemento-enamel junction (CEJ) to the most apical extension of the gingival margin.

Recession width (RW), the distance between the mesial gingival margin and the distal gingival margin of the tooth measured from the widest point of the recession.

Recession width (RW), the distance between the mesial gingival margin and the distal gingival margin of the tooth measured from the widest point of the recession.

Recession width (RW), the distance between the mesial gingival margin and the distal gingival margin of the tooth measured from the widest point of the recession.

Recession width (RW), the distance between the mesial gingival margin and the distal gingival margin of the tooth measured from the widest point of the recession.

Probing pocket depth (PD), measured from the gingival margin to the bottom of the gingival sulcus.

Probing pocket depth (PD), measured from the gingival margin to the bottom of the gingival sulcus.

Probing pocket depth (PD), measured from the gingival margin to the bottom of the gingival sulcus.

Probing pocket depth (PD), measured from the gingival margin to the bottom of the gingival sulcus.

Clinical attachment level (CAL), measured from the cementoenamel junction to the bottom of the gingival sulcus.

Clinical attachment level (CAL), measured from the cementoenamel junction to the bottom of the gingival sulcus.

Clinical attachment level (CAL), measured from the cementoenamel junction to the bottom of the gingival sulcus.

Clinical attachment level (CAL), measured from the cementoenamel junction to the bottom of the gingival sulcus.

Keratinized tissue change (KTC), GT change (GTC), root coverage, clinical attachment gain (CAG) were calculated in millimeters and percentages.

Keratinized tissue change (KTC), GT change (GTC), root coverage, clinical attachment gain (CAG) were calculated in millimeters and percentages.

Keratinized tissue change (KTC), GT change (GTC), root coverage, clinical attachment gain (CAG) were calculated in millimeters and percentages.

Keratinized tissue change (KTC), GT change (GTC), root coverage, clinical attachment gain (CAG) were calculated in millimeters and percentages.

Wound healing index (WHI) was recorded two-weeks after surgery. The wound surface was visually inspected and the soft tissue healing was defined as 'uneventful' (score 1), 'slightly disturbed' (score 2) or 'poor' (score 3) based on the presence and severity of the items including patient discomfort, erythema, edema, suppuration and flap dehiscence.

Tissue appearance (TA) was evaluated by asking the patients to score the consistency, contour, color match, keloid formation degree and contiguity of their treated sites at T2. The scores were collected as points, shown in parentheses, by asking the consistency as firm (1p) or spongy (0p); contour as presence (2p) or absence (0p) of knife-edged and scalloped gingival margin; color match as excellent (3p), good (2p), adequate (1p) or unsatisfactory (0p); keloid formation degree as absent (1p) or present (0p); contiguity as the presence (-1p) or absence (0p) of each perceptible incision mark.

Dentine hypersensitivity (DH) was evaluated with air evaporative stimulus method at baseline and T2. After placement of finger(s) for preserving the nearby teeth, the recession sites were subjected to evaporative stimulus comprised of 1-second air blast from 1 to 3 mm distance by using the air spray at 40-65 psi pressure and 19±50C. After application, the patients were requested to give a score to their DH between 0 (=no pain) and 10 (=extreme pain).

Patient expectations (PE) were evaluated by requesting from the patients to rate their treatment results at T2, as satisfactory or not, in terms of appearance, experience and obtained root coverage.

Aesthetics (A) was evaluated by the patient at T1 by rating its level as excellent, good, fair or poor.