Comparison of minimally invasive coronally advanced flap and modified coronally advanced flap for the management of multiple adjacent gingival recession defects: A split mouth randomized control trial

Introduction: Various minimally invasive surgical approaches are proposed for the management of gingival recession. A modified surgical approach coined as minimally invasive coronally advanced flap (MICAF) was compared with modified coronally advanced flap (MCAF) for the management of multiple adjacent gingival recession defects. Materials and methods: Seven systemically healthy subjects with bilateral multiple adjacent maxillary facial gingival recession defects (Miller I) were included in this study. In each patient, MICAF performed on one side and on the other side MCAF was performed. Comparisons of the surgical sites were made with clinical measurements at 6 months follow-up. Results: No statistically significant differences were observed between MICAF and MCAF sites in the change in gingival recession depth, gingival recession width, clinical attachment level, width of the keratinized tissue, mean, and complete root coverage after 6 months. However, patient reported outcomes of esthetics and postoperative morbidity were statistically significant (P <0.001) between the MICAF and the MCAF sides with better results in the MICAF side. Conclusions: Within the confines of this study, the results depicted that MICAF is more patient-friendly procedure with better patient acceptance. Further, long-term studies with more sample sizes are needed for a stronger evidence base. Clinical Significance: Miller Class I gingival recessions can be treated with the MICAF with successful clinical outcomes and patient acceptance. This paper reports the clinical and patient reported outcomes of the MICAF and the MCAF.