Clinical and aesthetic outcomes of different papillae width following modified coronally advanced tunnel technique: A retrospective study

ObjectiveThis study was to investigate whether the width of the interdental papillae could contribute to clinical and aesthetic outcomes of the modified coronally advanced tunnel technique (MCAT).Materials and MethodsA total of 28 patients with 70 class RT1 single and multiple gingival recessions (GRs) were treated by MCAT between March 2017 and March 2021. The apex angle of the mesial and distal papillae adjacent to the involved tooth were recorded at baseline. Clinical outcomes (mean root coverage (mRC) and complete root coverage (CRC)) were recorded at 12 months after surgery. Periodontal clinical parameters (keratinized tissue width (KTW), gingival index (GI), plaque index (PLI), periodontal probing depth (PPD), and clinical attachment loss (CAL)) were recorded at baseline and 12 months after surgery. Aesthetic evaluation was carried out using the root coverage esthetic score (RES) and patients’ visual analogue scale (VAS). The possible relationship between papilla width and clinical and/or aesthetic outcomes was discerned by multiple linear regression and logistic regression.ResultsThe mean width of papilla ranged from 22.6° to 74.65° with a median of 42.32° (IQR: 16.98°). For single GRs, the papilla width was not significantly correlated to mRC, RES, CRC, VAS gain, CAL gain, and KTW gain. The RES and CRC were only associated with papilla width in multiple GRs (P = 0.012). At 12 months, 95.79 ± 10.17% and 92.94 ± 10.64% of mRC were obtained for multiple GRs and single GRs, respectively. Better results in terms of CRC were obtained from multiple GRs compared with single GRs (78.94% vs. 66.67%). For aesthetic outcomes, 8.84 ± 1.54 and 9.16 ± 1.53 of RES were observed at single and multiple GR defects.ConclusionsThe CRC and RES of multiple GRs following MCAT is significantly correlated to papillae width. Relatively wide gingival papillae tend to have a greater chance to achieve complete root surface coverage.Clinical relevance:The width of the gingival papilla helps to speculate on the clinical outcome of root surface coverage. Although the findings are not yet highly predictable, the MCAT can yield better results in the wider gingival papilla area.