Three‐dimensional quantitative measurement of buccal augmented tissue with modified coronally advanced tunnel technique and de‐epithelialized gingival graft: a prospective case series

BACKGROUND: The aim of this study is to investigate three-dimensional quantitative analysis of buccal augmented tissue alterations after surgery using a modified coronally advanced tunnel (MCAT) technique combined with a de-epithelialized gingival graft (DGG) within 1 year post-op, based on intraoral scanning. METHODS: 25 Cairo class I gingival recession defects were treated using an MCAT technique with DGG. Digital impressions were taken using an intraoral scanner at baseline, 2 weeks, 6 weeks, 3 months, and 1 year after the surgery. Three-dimensional quantitative measurements within 1 year were analyzed for buccal augmented tissue after surgery, including postoperative gingival height gain (GHG), area gain (GAG), volume gain (GVG) and mean thickness (GMT) of region of interest, as well as the tissue thickness change at 1, 2, and 3 mm (TTC1, TTC2, and TTC3) apical to the cemento-enamel junction. RESULTS: Postoperative GHG, GAG, GVG, and GMT were distinctly encountered at 2 weeks post-op, then gradually decreased. At 1 year, GHG, GAG, GVG, and GMT were 2.211 ± 0.717 mm, 7.614 ± 2.511 mm(2), 7.690 ± 4.335 mm(3) and 0.965 ± 0.372 mm, respectively. Significant decreases were recorded between 6 weeks and 1 year in terms of GHG, GAG, and GVG. The GMT was sustained after 6 weeks with an increase of nearly 1 mm at 1 year. TTC1 and TTC2 yielded thicker tissue change than TTC3. CONCLUSIONS: Three-dimensional quantitative measurements taken via intraoral scanning showed that buccal augmented tissue acquired via MCAT with DGG tends to be stable after 3 months post-op. Digital measurement can be applied in periodontal plastic surgery as a clinically feasible and non-invasive evaluation method for achieving volumetric outcomes. TRIAL REGISTRATION: This study was retrospectively registered in the Chinese Clinical Trial Registry: ChiCTR1900026768. Date of registration: 21/10/2019.