Coronally advanced flap versus tunnel technique for the treatment of peri-implant soft tissue dehiscences with the connective tissue graft: A randomized, controlled clinical trial.
complication
dental implant
recession
soft tissue augmentation
ultrasonography
Journal
Journal of clinical periodontology
ISSN: 1600-051X
Titre abrégé: J Clin Periodontol
Pays: United States
ID NLM: 0425123
Informations de publication
Date de publication:
07 2023
07 2023
Historique:
revised:
27
02
2023
received:
17
10
2022
accepted:
10
03
2023
medline:
12
6
2023
pubmed:
20
3
2023
entrez:
19
3
2023
Statut:
ppublish
Résumé
To evaluate the efficacy of coronally advanced flap (CAF) versus tunnel technique (TUN) in covering isolated mid-facial peri-implant soft tissue dehiscences (PSTDs). Twenty-eight participants presenting with isolated non-molar implants exhibiting PSTDs were enrolled and randomized to receive either CAF or TUN, both with a connective tissue graft (CTG). The primary outcome of the study was the percentage of mean PSTD coverage at 12 months. Secondary endpoints included the frequency of complete PSTD coverage, changes in keratinized mucosa width (KMW) and horizontal mucosal thickness (MT), as assessed with transgingival probing, 3D optical scanning and ultrasonography, professional aesthetic evaluation and patient-reported outcome measures (PROMs). At 12 months, the mean PSTD coverage of the CAF and TUN groups was 90.23% and 59.76%, respectively (p = .03). CAF-treated sites showed a substantially higher frequency of complete PSTD coverage (p = .07), together with significantly greater gain of KMW (p = .01), increase in MT (p = .02), volumetric gain (p < .01) and professional aesthetic outcomes (p = .01). Both interventions showed an improvement in patient-reported aesthetics and a reduction of the anxiety related to the appearance of the implant compared to baseline, with the CAF group obtaining significantly higher scores (p = .03 for both PROMs). CAF + CTG resulted in superior PSTD coverage outcomes, greater gain in KMW and MT, and better PROMs than TUN + CTG for the treatment of isolated PSTDs (ClinicalTrials.gov NCT03498911).
Banques de données
ClinicalTrials.gov
['NCT03498911']
Types de publication
Randomized Controlled Trial
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
980-995Informations de copyright
© 2023 The Authors. Journal of Clinical Periodontology published by John Wiley & Sons Ltd.
Références
Anderson, L. E., Inglehart, M. R., El-Kholy, K., Eber, R., & Wang, H. L. (2014). Implant associated soft tissue defects in the anterior maxilla: A randomized control trial comparing subepithelial connective tissue graft and acellular dermal matrix allograft. Implant Dentistry, 23(4), 416-425. https://doi.org/10.1097/ID.0000000000000122
Araujo, M. G., & Lindhe, J. (2018). Peri-implant health. Journal of Clinical Periodontology, 45(Suppl 20), S230-S236. https://doi.org/10.1111/jcpe.12952
Aroca, S., Molnar, B., Windisch, P., Gera, I., Salvi, G. E., Nikolidakis, D., & Sculean, A. (2013). Treatment of multiple adjacent miller class I and II gingival recessions with a modified Coronally advanced tunnel (MCAT) technique and a collagen matrix or palatal connective tissue graft: A randomized, controlled clinical trial. Journal of Clinical Periodontology, 40(7), 713-720. https://doi.org/10.1111/jcpe.12112
Avila-Ortiz, G., Gonzalez-Martin, O., Couso-Queiruga, E., & Wang, H. L. (2020). The peri-implant phenotype. Journal of Periodontology, 91(3), 283-288. https://doi.org/10.1002/JPER.19-0566
Azaripour, A., Kissinger, M., Farina, V. S., Van Noorden, C. J., Gerhold-Ay, A., Willershausen, B., & Cortellini, P. (2016). Root coverage with connective tissue graft associated with coronally advanced flap or tunnel technique: A randomized, double-blind, mono-Centre clinical trial. Journal of Clinical Periodontology, 43(12), 1142-1150. https://doi.org/10.1111/jcpe.12627
Barootchi, S., Chan, H. L., Namazi, S. S., Wang, H. L., & Kripfgans, O. D. (2020). Ultrasonographic characterization of lingual structures pertinent to oral, periodontal, and implant surgery. Clinical Oral Implants Research, 31, 352-359. https://doi.org/10.1111/clr.13573
Barootchi, S., Tavelli, L., Di Gianfilippo, R., Shedden, K., Oh, T. J., Rasperini, G., Neiva, R., Giannobile, W. V., & Wang, H. L. (2022). Soft tissue phenotype modification predicts gingival margin long-term (10-year) stability: Longitudinal analysis of six randomized clinical trials. Journal of Clinical Periodontology, 49, 672-683. https://doi.org/10.1111/jcpe.13641
Barootchi, S., Tavelli, L., Majzoub, J., Chan, H. L., Wang, H. L., & Kripfgans, O. D. (2021). Ultrasonographic tissue perfusion in Peri-implant health and disease. Journal of Dental Research, 220345211035684, 278-285. https://doi.org/10.1177/00220345211035684
Barootchi, S., Tavelli, L., Zucchelli, G., Giannobile, W. V., & Wang, H. L. (2020). Gingival phenotype modification therapies on natural teeth: A network meta-analysis. Journal of Periodontology, 91(11), 1386-1399. https://doi.org/10.1002/JPER.19-0715
Barootchi, S., & Wang, H. L. (2021). Peri-implant diseases: Current understanding and management. The International Journal of Oral Implantology, 14(3), 263-282.
Berglundh, T., Armitage, G., Araujo, M. G., Avila-Ortiz, G., Blanco, J., Camargo, P. M., Chen, S., Cochran, D., Figuero, E., Hämmerle, C. H. F., Heitz-Mayfield, L. J. A., Huynh-Ba, G., Iacono, V., Too, K. T., Lambert, F., McCauley, L., Quirynen, M., Renvert, S., … Zitzmann, N. (2018). Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 world workshop on the classification of periodontal and Peri-implant diseases and conditions. Journal of Clinical Periodontology, 45(Suppl 20), S286-S291. https://doi.org/10.1111/jcpe.12957
Bohner, L., Habor, D., Tortamano, P., Radermacher, K., Wolfart, S., & Marotti, J. (2019). Assessment of buccal bone surrounding dental implants using a high-frequency ultrasound scanner. Ultrasound in Medicine & Biology, 45(6), 1427-1434. https://doi.org/10.1016/j.ultrasmedbio.2019.02.002
Bonino, F., Steffensen, B., Natto, Z., Hur, Y., Holtzman, L. P., & Weber, H. P. (2018). Prospective study of the impact of peri-implant soft tissue properties on patient-reported and clinically assessed outcomes. Journal of Periodontology, 89(9), 1025-1032. https://doi.org/10.1002/JPER.18-0031
Borges, T., Fernandes, D., Almeida, B., Pereira, M., Martins, D., Azevedo, L., & Marques, T. (2020). Correlation between alveolar bone morphology and volumetric dimensional changes in immediate maxillary implant placement: A 1-year prospective cohort study. Journal of Periodontology, 91(9), 1167-1176. https://doi.org/10.1002/JPER.19-0606
Burkhardt, R., Joss, A., & Lang, N. P. (2008). Soft tissue dehiscence coverage around endosseous implants: A prospective cohort study. Clinical Oral Implants Research, 19(5), 451-457. https://doi.org/10.1111/j.1600-0501.2007.01497.x
Buser, D., Sennerby, L., & De Bruyn, H. (2017). Modern implant dentistry based on osseointegration: 50 years of progress, current trends and open questions. Periodontology 2000, 73(1), 7-21. https://doi.org/10.1111/prd.12185
Cairo, F., Cortellini, P., Nieri, M., Pilloni, A., Barbato, L., Pagavino, G., & Tonetti, M. (2020). Coronally advanced flap and composite restoration of the enamel with or without connective tissue graft for the treatment of single maxillary gingival recession with non-carious cervical lesion. A randomized controlled clinical trial. Journal of Clinical Periodontology, 47(3), 362-371. https://doi.org/10.1111/jcpe.13229
Chan, H. L., & Kripfgans, O. D. (2020). Ultrasonography for diagnosis of peri-implant diseases and conditions: A detailed scanning protocol and case demonstration. Dento Maxillo Facial Radiology, 49(7), 20190445. https://doi.org/10.1259/dmfr.20190445
Chan, H. L., Sinjab, K., Chung, M. P., Chiang, Y. C., Wang, H. L., Giannobile, W. V., & Kripfgans, O. D. (2017). Non-invasive evaluation of facial crestal bone with ultrasonography. PLoS One, 12(2), e0171237. https://doi.org/10.1371/journal.pone.0171237
Chan, H. L., Sinjab, K., Li, J., Chen, Z., Wang, H. L., & Kripfgans, O. D. (2018). Ultrasonography for noninvasive and real-time evaluation of peri-implant tissue dimensions. Journal of Clinical Periodontology, 45, 986-995. https://doi.org/10.1111/jcpe.12918
Chan, H. L., Wang, H. L., Fowlkes, J. B., Giannobile, W. V., & Kripfgans, O. D. (2017). Non-ionizing real-time ultrasonography in implant and oral surgery: A feasibility study. Clinical Oral Implants Research, 28(3), 341-347. https://doi.org/10.1111/clr.12805
Clementini, M., Castelluzzo, W., Ciaravino, V., Agostinelli, A., Vignoletti, F., Ambrosi, A., & De Sanctis, M. (2020). The effect of immediate implant placement on alveolar ridge preservation compared to spontaneous healing after tooth extraction: Soft tissue findings from a randomized controlled clinical trial. Journal of Clinical Periodontology, 47(12), 1536-1546. https://doi.org/10.1111/jcpe.13369
Elani, H. W., Starr, J. R., Da Silva, J. D., & Gallucci, G. O. (2018). Trends in dental implant use in the U.S., 1999-2016, and projections to 2026. Journal of Dental Research, 97(13), 1424-1430. https://doi.org/10.1177/0022034518792567
Fickl, S., Schneider, D., Zuhr, O., Hinze, M., Ender, A., Jung, R. E., & Hurzeler, M. B. (2009). Dimensional changes of the ridge contour after socket preservation and buccal overbuilding: An animal study. Journal of Clinical Periodontology, 36(5), 442-448. https://doi.org/10.1111/j.1600-051X.2009.01381.x
Fons-Badal, C., Alonso Perez-Barquero, J., Martinez-Martinez, N., Faus-Lopez, J., Fons-Font, A., & Agustin-Panadero, R. (2019). A novel, fully digital approach to quantifying volume gain after soft tissue graft surgery. A pilot study. Journal of Clinical Periodontology, 47, 614-620. https://doi.org/10.1111/jcpe.13235
Frisch, E., & Ratka-Kruger, P. (2020). A new technique for peri-implant recession treatment: Partially epithelialized connective tissue grafts. Description of the technique and preliminary results of a case series. Clinical Implant Dentistry and Related Research, 22(3), 403-408. https://doi.org/10.1111/cid.12897
Galarraga-Vinueza, M. E., Obreja, K., Magini, R., Sculean, A., Sader, R., & Schwarz, F. (2020). Volumetric assessment of tissue changes following combined surgical therapy of peri-implantitis: A pilot study. Journal of Clinical Periodontology, 47(9), 1159-1168. https://doi.org/10.1111/jcpe.13335
Galarraga-Vinueza, M. E., & Tavelli, L. (2022). Soft tissue features of peri-implant diseases and related treatment. Clinical Implant Dentistry and Related Research. https://doi.org/10.1111/cid.13156
Giannobile, W. V., Jung, R. E., Schwarz, F., & Groups of the 2nd Osteology Foundation Consensus, M. (2018). Evidence-based knowledge on the aesthetics and maintenance of peri-implant soft tissues: Osteology foundation consensus report part 1-effects of soft tissue augmentation procedures on the maintenance of peri-implant soft tissue health. Clinical Oral Implants Research, 29(Suppl 15), 7-10. https://doi.org/10.1111/clr.13110
Grischke, J., Karch, A., Wenzlaff, A., Foitzik, M. M., Stiesch, M., & Eberhard, J. (2019). Keratinized mucosa width is associated with severity of peri-implant mucositis. A cross-sectional study. Clinical Oral Implants Research, 30(5), 457-465. https://doi.org/10.1111/clr.13432
Happe, A., Stimmelmayr, M., Schlee, M., & Rothamel, D. (2013). Surgical management of peri-implant soft tissue color mismatch caused by shine-through effects of restorative materials: One-year follow-up. The International Journal of Periodontics & Restorative Dentistry, 33(1), 81-88.
Heitz-Mayfield, L. J. A., & Salvi, G. E. (2018). Peri-implant mucositis. Journal of Clinical Periodontology, 45(Suppl 20), S237-S245. https://doi.org/10.1111/jcpe.12953
Hosseini, M., Worsaae, N., & Gotfredsen, K. (2019). Tissue changes at implant sites in the anterior maxilla with and without connective tissue grafting: A five-year prospective study. Clinical Oral Implants Research, 31, 18-28. https://doi.org/10.1111/clr.13540
Lee, C. T., Hamalian, T., & Schulze-Spate, U. (2015). Minimally invasive treatment of soft tissue deficiency around an implant-supported restoration in the esthetic zone: Modified VISTA technique case report. The Journal of Oral Implantology, 41(1), 71-76. https://doi.org/10.1563/AAID-JOI-D-13-00043
Linares, A., Rubinos, A., Punal, A., Munoz, F., & Blanco, J. (2022). Regeneration of keratinized tissue around teeth and implants following coronal repositioning of alveolar mucosa with and without a connective tissue graft. An experimental study in dogs. Journal of Clinical Periodontology, 49, 1133-1144. https://doi.org/10.1111/jcpe.13673
Mazzotti, C., Stefanini, M., Felice, P., Bentivogli, V., Mounssif, I., & Zucchelli, G. (2018). Soft-tissue dehiscence coverage at peri-implant sites. Periodontology 2000, 77(1), 256-272. https://doi.org/10.1111/prd.12220
McGuire, M. K., Scheyer, E. T., Nevins, M. L., Neiva, R., Cochran, D. L., Mellonig, J. T., Giannobile, W. V., & Bates, D. (2011). Living cellular construct for increasing the width of keratinized gingiva: Results from a randomized, within-patient, controlled trial. Journal of Periodontology, 82(10), 1414-1423. https://doi.org/10.1902/jop.2011.100671
Neves, F., Augusto Silveira, C., Mathias-Santamaria, I. F., Miguel, M. M. V., Ferraz, L. F. F., Casarin, R. C. V., Sallum, E. A., Tatamis, D. N., & Santamaria, M. P. (2019). Randomized clinical trial evaluating single maxillary gingival recession treatment with connective tissue graft and tunnel or trapezoidal flap: 2-year follow-up. Journal of Periodontology, 91, 1018-1026. https://doi.org/10.1002/JPER.19-0436
Parvini, P., Galarraga-Vinueza, M. E., Obreja, K., Magini, R. S., Sader, R., & Schwarz, F. (2021). Prospective study assessing three-dimensional changes of mucosal healing following soft tissue augmentation using free gingival grafts. Journal of Periodontology, 92(3), 400-408. https://doi.org/10.1002/JPER.19-0640
Roccuzzo, M., Gaudioso, L., Bunino, M., & Dalmasso, P. (2014). Surgical treatment of buccal soft tissue recessions around single implants: 1-year results from a prospective pilot study. Clinical Oral Implants Research, 25(6), 641-646. https://doi.org/10.1111/clr.12149
Romandini, M., Lima, C., Pedrinaci, I., Araoz, A., Soldini, M. C., & Sanz, M. (2021). Prevalence and risk/protective indicators of peri-implant diseases: A university-representative cross-sectional study. Clinical Oral Implants Research, 32(1), 112-122. https://doi.org/10.1111/clr.13684
Romandini, M., Pedrinaci, I., Lima, C., Costanza Soldini, M., Araoz, A., & Sanz, M. (2020). Prevalence and risk/protective indicators of buccal soft tissue dehiscence around dental implants. Journal of Clinical Periodontology, 48, 455-463. https://doi.org/10.1111/jcpe.13417
Sanz-Martin, I., Regidor, E., Navarro, J., Sanz-Sanchez, I., Sanz, M., & Ortiz-Vigon, A. (2020). Factors associated with the presence of peri-implant buccal soft tissue dehiscences: A case-control study. Journal of Periodontology, 91, 1003-1010. https://doi.org/10.1002/JPER.19-0490
Schmitt, C. M., Bruckbauer, P., Schlegel, K. A., Buchbender, M., Adler, W., & Matta, R. E. (2021). Volumetric soft tissue alterations in the early healing phase after peri- implant soft tissue contour augmentation with a porcine collagen matrix versus the autologous connective tissue graft: A controlled clinical trial. Journal of Clinical Periodontology, 48(1), 145-162. https://doi.org/10.1111/jcpe.13387
Sculean, A., Chappuis, V., & Cosgarea, R. (2017). Coverage of mucosal recessions at dental implants. Periodontology 2000, 73(1), 134-140. https://doi.org/10.1111/prd.12178
Sculean, A., Gruber, R., & Bosshardt, D. D. (2014). Soft tissue wound healing around teeth and dental implants. Journal of Clinical Periodontology, 41(Suppl 15), S6-S22. https://doi.org/10.1111/jcpe.12206
Siqueira, R., Sinjab, K., Pan, Y. C., Soki, F., Chan, H. L., & Kripfgans, O. (2021). Comprehensive peri-implant tissue evaluation with ultrasonography and cone-beam computed tomography: A pilot study. Clinical Oral Implants Research, 32, 777-785. https://doi.org/10.1111/clr.13758
Tattan, M., Sinjab, K., Lee, E., Arnett, M., Oh, T. J., Wang, H. L., Chan, H. L., & Kripfgans, O. D. (2019). Ultrasonography for chairside evaluation of periodontal structures: A pilot study. Journal of Periodontology, 91, 890-899. https://doi.org/10.1002/JPER.19-0342
Tavelli, L., Asa'ad, F., Acunzo, R., Pagni, G., Consonni, D., & Rasperini, G. (2018). Minimizing patient morbidity following palatal gingival harvesting: A randomized controlled clinical study. The International Journal of Periodontics & Restorative Dentistry, 38(6), e127-e134. https://doi.org/10.11607/prd.3581
Tavelli, L., Barootchi, S., Avila-Ortiz, G., Urban, I. A., Giannobile, W. V., & Wang, H. L. (2021). Peri-implant soft tissue phenotype modification and its impact on peri-implant health: A systematic review and network meta-analysis. Journal of Periodontology, 92(1), 21-44. https://doi.org/10.1002/JPER.19-0716
Tavelli, L., Barootchi, S., Cairo, F., Rasperini, G., Shedden, K., & Wang, H. L. (2019). The effect of time on root coverage outcomes: A network meta-analysis. Journal of Dental Research, 98(11), 1195-1203. https://doi.org/10.1177/0022034519867071
Tavelli, L., Barootchi, S., Majzoub, J., Chan, H. L., Giannobile, W. V., Wang, H. L., & Kripfgans, O. D. (2021). Ultrasonographic tissue perfusion analysis at implant and palatal donor sites following soft tissue augmentation: A clinical pilot study. Journal of Clinical Periodontology, 48(4), 602-614. https://doi.org/10.1111/jcpe.13424
Tavelli, L., Barootchi, S., Majzoub, J., Chan, H. L., Stefanini, M., Zucchelli, G., Kripfgans, O. D., Wang, H. L., & Urban, I. A. (2021). Prevalence and risk indicators of midfacial peri-implant soft tissue dehiscence at single site in the esthetic zone: A cross-sectional clinical and ultrasonographic study.Journal of. Periodontology, 93, 857-866. https://doi.org/10.1002/JPER.21-0402
Tavelli, L., Barootchi, S., Majzoub, J., Siqueira, R., Mendonca, G., & Wang, H. L. (2021). Volumetric changes at implant sites: A systematic appraisal of traditional methods and optical scanning-based digital technologies. Journal of Clinical Periodontology, 48(2), 315-334. https://doi.org/10.1111/jcpe.13401
Tavelli, L., Barootchi, S., Nguyen, T. V. N., Tattan, M., Ravida, A., & Wang, H. L. (2018). Efficacy of tunnel technique in the treatment of localized and multiple gingival recessions: A systematic review and meta-analysis. Journal of Periodontology, 89(9), 1075-1090. https://doi.org/10.1002/JPER.18-0066
Tavelli, L., Heck, T., De Souza, A. B., Stefanini, M., Zucchelli, G., & Barootchi, S. (2023). Implant esthetic complications: Anatomical, prosthetic, and patient-centered considerations for treatment. The International Journal of Periodontics & Restorative Dentistry.
Tavelli, L., Ravida, A., Saleh, M. H. A., Maska, B., Del Amo, F. S., Rasperini, G., & Wang, H. L. (2019). Pain perception following epithelialized gingival graft harvesting: A randomized clinical trial. Clinical Oral Investigations, 23(1), 459-468. https://doi.org/10.1007/s00784-018-2455-5
Thoma, D. S., Gasser, T. J. W., Jung, R. E., & Hammerle, C. H. F. (2020). Randomized controlled clinical trial comparing implant sites augmented with a volume-stable collagen matrix or an autogenous connective tissue graft: 3-year data after insertion of reconstructions. Journal of Clinical Periodontology, 47(5), 630-639. https://doi.org/10.1111/jcpe.13271
Thoma, D. S., Strauss, F. J., Mancini, L., Gasser, T. J. W., & Jung, R. E. (2022). Minimal invasiveness in soft tissue augmentation at dental implants: A systematic review and meta-analysis of patient-reported outcome measures. Periodontology 2000, 2000. https://doi.org/10.1111/prd.12465
Tian, J., Wei, D., Zhao, Y., Di, P., Jiang, X., & Lin, Y. (2019). Labial soft tissue contour dynamics following immediate implants and immediate provisionalization of single maxillary incisors: A 1-year prospective study. Clinical Implant Dentistry and Related Research, 21(3), 492-502. https://doi.org/10.1111/cid.12786
Tonetti, M. S., Cortellini, P., Pellegrini, G., Nieri, M., Bonaccini, D., Allegri, M., Bouchard, P., Cairo, F., Conforti, G., Fourmousis, I., Graziani, F., Guerrero, A., Halben, J., Malet, J., Rasperini, G., Topoli, H., Watchel, H., Wallkamm, B., Zabalegui, I., & Zuhr, O. (2018). Xenogenic collagen matrix or autologous connective tissue graft as adjunct to coronally advanced flaps for coverage of multiple adjacent gingival recession: Randomized trial assessing non-inferiority in root coverage and superiority in oral health-related quality of life. Journal of Clinical Periodontology, 45(1), 78-88. https://doi.org/10.1111/jcpe.12834
Zucchelli, G., Amore, C., Sforza, N. M., Montebugnoli, L., & De Sanctis, M. (2003). Bilaminar techniques for the treatment of recession-type defects. A comparative clinical study. Journal of Clinical Periodontology, 30(10), 862-870. https://doi.org/10.1034/j.1600-051x.2003.00397.x
Zucchelli, G., Barootchi, S., Tavelli, L., Stefanini, M., Rasperini, G., & Wang, H. L. (2021). Implant soft tissue dehiscence coverage esthetic score (IDES): A pilot within- and between-rater analysis of consistency in objective and subjective scores. Clinical Oral Implants Research, 32(3), 349-358. https://doi.org/10.1111/clr.13706
Zucchelli, G., Mazzotti, C., Mounssif, I., Marzadori, M., & Stefanini, M. (2013). Esthetic treatment of peri-implant soft tissue defects: A case report of a modified surgical-prosthetic approach. The International Journal of Periodontics & Restorative Dentistry, 33(3), 327-335. https://doi.org/10.11607/prd.1632
Zucchelli, G., Mazzotti, C., Mounssif, I., Mele, M., Stefanini, M., & Montebugnoli, L. (2013). A novel surgical-prosthetic approach for soft tissue dehiscence coverage around single implant. Clinical Oral Implants Research, 24(9), 957-962. https://doi.org/10.1111/clr.12003
Zucchelli, G., Mele, M., Stefanini, M., Mazzotti, C., Marzadori, M., Montebugnoli, L., & de Sanctis, M. (2010). Patient morbidity and root coverage outcome after subepithelial connective tissue and de-epithelialized grafts: A comparative randomized-controlled clinical trial. Journal of Clinical Periodontology, 37(8), 728-738. https://doi.org/10.1111/j.1600-051X.2010.01550.x
Zucchelli, G., Mounssif, I., Mazzotti, C., Montebugnoli, L., Sangiorgi, M., Mele, M., & Stefanini, M. (2014). Does the dimension of the graft influence patient morbidity and root coverage outcomes? A randomized controlled clinical trial. Journal of Clinical Periodontology, 41(7), 708-716. https://doi.org/10.1111/jcpe.12256
Zucchelli, G., Tavelli, L., McGuire, M. K., Rasperini, G., Feinberg, S. E., Wang, H. L., & Giannobile, W. V. (2020). Autogenous soft tissue grafting for periodontal and peri-implant plastic surgical reconstruction. Journal of Periodontology, 91(1), 9-16. https://doi.org/10.1002/JPER.19-0350
Zucchelli, G., Tavelli, L., Stefanini, M., Barootchi, S., Mazzotti, C., Gori, G., & Wang, H. L. (2019). Classification of facial peri-implant soft tissue dehiscence/deficiencies at single implant sites in the esthetic zone. Journal of Periodontology, 90(10), 1116-1124. https://doi.org/10.1002/JPER.18-0616
Zucchelli, G., Tavelli, L., Stefanini, M., Barootchi, S., & Wang, H. L. (2021). The coronally advanced flap technique revisited: Treatment of peri-implant soft tissue dehiscences. The International Journal of Oral Implantology, 14(4), 351-365.
Zuhr, O., Rebele, S. F., Schneider, D., Jung, R. E., & Hurzeler, M. B. (2014). Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivative for root coverage: A RCT using 3D digital measuring methods. Part I. clinical and patient-centred outcomes. Journal of Clinical Periodontology, 41(6), 582-592. https://doi.org/10.1111/jcpe.12178