The Effects of Vertically Coronally Advanced Flap and Free Gingival Graft Techniques on Shallow Vestibule: a Randomized Comparative Prospective Trial

Objectives The present study aimed to compare the influence of vertically coronally advanced flap (V-CAF) and free gingival graft (FGG) techniques on shallow vestibule depth (VD). Materials and methods Parallel-arm randomized clinical trial was conducted on 38 sites treated with either FGG or V-CAF. Periodontal variables (VD, recession depth and width, probing depth, clinical attachment level, keratinized tissue height (KTH), and tissue thickness (TT)), clinician- and patient-based subjective variables were assessed. Results All periodontal variables showed significant improvements in both groups at all follow-up intervals compared to baseline ( p < 0.05). Both groups increased VD compared to baseline. RC and CRC were similar after treatment for both techniques. FGG provided a greater increase in KTH ( p < 0.001) and VD (VD1, p = 0.02 and VD2, p < 0.001) while V-CAF exhibited more TT gain ( p = 0.002). Except overall tissue appearance that was better in V-CAF ( p < 0.001), no inter-group significant difference existed in patient-based variables. Conclusions Both techniques were significantly effective in VD increasing. While both techniques were equally successful in RC, V-CAF provided higher TT gain and better tissue appearance. V-CAF can be chosen instead of FGG in the treatment of recessions with shallow VD. Clinical relevance It can be recommended to prefer V-CAF instead of FGG in the treatment of shallow vestibule. Trial registration number NCT05777811 (clinicaltrials.gov).