Discussion
teeth
The results from the present study indicate that both surgical interventions (TUN and CAF) were of similar efficacy in terms of root coverage, early wound healing, and esthetic outcomes at 3 and 6 months. However, TUN demonstrated a significantly higher increase in KT and a shorter surgery duration. Similarly, PROMS were significantly better in patients treated with TUN during the first two postoperative weeks, although the overall and condition-specific quality of life resulted similar for both treatments at 6 months.These results agree with three previous RCTs comparing TUN with CAF and reporting similar root coverage outcomes [In the present RCT, the only significant difference in the clinical outcomes occurred for the increase in KT, which was in favor of TUN. This finding is also consistent with three previous reports [Although one out of three teeth treated with TUN showed uncovered CEJ during early healing (1–4 weeks), at 6 months around 80% of the sites demonstrated CRC, which indicates the occurrence of creeping attachment on teeth treated with this surgical technique. Conversely, teeth treated with CAF showed an opposite trend, since CRC decreased from 97.6% at week 1 to 78.1% at 6 months.In the present study, patients operated with the test intervention (TUN) reported better PROMs and experienced a faster surgical intervention (19-min difference). These results are not consistent with a previous RCT reporting shorter surgery duration and lesser morbidity in patients treated with CAF [In this RCT, we tried to standardize the CTG harvesting procedure between groups, by undertaking the randomization once the CTG was harvested. However, the CAF surgical technique has been recently modified by advocating a minimal-size application of CTG [The results of this trial answer to a clinically relevant question, and they are supported by a solid study design. However, some limitations should be taken into account, including the lack of blinding of the outcome assessors and the short follow-up (6 months). Moreover, despite a sample size calculation was performed, the statistical power may have been limited to detect smaller—yet clinically relevant—differences between groups on the primary outcome. Furthermore, data on type of GR (RT1/RT2) and gingival thickness was not collected, preventing the verification of a balanced distribution between groups of these prognostic parameters. Finally, both surgical operators were trained and experienced with the use of both techniques which—despite the dual-center setting—may reduce the whole generalizability of the present findings.