Clinical Evaluation of Lateral Pedicle Flap Stabilized with Cyanoacrylate Tissue Adhesive: A Randomized Controlled Clinical Trial

Abstract

Context: Gingival recession is the most common mucogingival defect and is susceptible to tooth hypersensitivity, root caries, and esthetic problems if left untreated. A lateral pedicle flap is used to cover denuded roots that have adequate donor tissue laterally and adequate vestibular depth. A carefully planned surgery needs proper immobilization of the flap at the recipient site and this can be achieved by proper wound closure technique with appropriate material such as sutures or tissue adhesives.

Aim: The aim of the present study is to evaluate the clinical outcomes of lateral pedicle flap stabilized with cyanoacrylate tissue adhesive and resorbable sutures.

Materials and methods: Twenty-two patients with Miller's class I and class II gingival recession were randomly divided into two groups: lateral pedicle flap stabilized with cyanoacrylate tissue adhesive (test) and lateral pedicle flap stabilized with resorbable sutures (control). Plaque index, gingival index, probing pocket depth, clinical attachment level, recession depth and width, height and thickness of keratinized gingiva were evaluated at baseline and 1^st and 3^rd month postoperatively. The percentage of root coverage was evaluated at the end of 3^rd month postoperatively.

Statistical analysis used: Intergroup comparisons for the clinical attachment level, recession depth, recession width, thickness of keratinized gingiva, and height of keratinized gingiva were made by Mann-Whitney test by analyzing the difference of two time periods. Intragroup comparisons were made by the Kruskal-Wallis test. Mann-Whitney test was used to compare the difference between various time periods within the group for all the selected variables.

Results: The mean plaque index and gingival index at the 1^st and 3^rd month were found to be statistically significant and did not present any significant influence over other clinical parameters evaluated. A partial root coverage was observed in both the groups (71.97% for the test group and 61.36% for the control group).

Conclusions: Cyanoacrylate tissue adhesive is clinically effective in the stabilization of the lateral pedicle flap and can be used as an alternative to resorbable sutures.

Keywords: Cyanoacrylate; gingival recession; lateral pedicle flap; mucogingival surgery; tissue adhesive.