Gingival Recession, Mucogingival SurgeryNCT07602829
V-Reverse Suture Technique Compared to Traditional Anchored Sling Suture in Treating Multiple Gingival Recession
A study testing coronally advanced tunnel with v-reverse suture and coronally advanced tunnel with anchored sling suture in people with Gingival Recession, Mucogingival Surgery, run by King Abdullah University Hospital at 1 site in Jordan.
Trial summary
The goal of this split-mouth pilot study is to study the effect of two different suturing techniques in root coverage using coronally advanced flap tunnel in multiple adjacent recession cases to see which technique will give superior outcomes in term of mean root coverage percentage, and root coverage esthetic score… Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Gingival Recession, Mucogingival Surgery
- What is being tested?
- coronally advanced tunnel with v-reverse suture and coronally advanced tunnel with anchored sling suture
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 7 participants
- Where
- 1 siteJordan
- Study dates
- 1 Apr 2025to 1 Jun 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Age ≥ 18 years
- Periodontally and systemically healthy;
- Good plaque control (FMPS < 20%)
- Presence of two quadrants exhibiting multiple (2 or more sites) adjacent RT1 or RT2 gingival recession ≥ 2 mm in at least one site.
- Non-smoker.
Who cannot join
- Smoking
- Pregnant or lactating women;
- Untreated periodontitis;
- Systemic disorders with compromised healing potential;
- Use of medications (immuno-suppressants, phenytoin, or anything else that might affect soft tissue healing);
- Undergoing radiotherapy;
Show all 10Show fewer
- History of mucogingival surgery.
- Presence of severe tooth malposition, rotation, or super-eruption.
- Presence of root caries or inadequate prosthetic restorations;
- Persistence of uncorrected gingival trauma from toothbrushing.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Modified Coronally Advanced Tunnel for Root Coverage With Sling Suture VS. V-Reverse Suture: A Slit-Mouth Pilot Study
The goal of this split-mouth pilot study is to study the effect of two different suturing techniques in root coverage using coronally advanced flap tunnel in multiple adjacent recession cases to see which technique will give superior outcomes in term of mean root coverage percentage, and root coverage esthetic score after 3-months.
The main questions it aims to answer are:
Read more
- Does a suturing technique gives superior mean root coverage percentage over another?
- Does a suturing technique gives superior root coverage esthetic score?
Researcher will compare between V-reverse suturing technique and anchored sling suture to see which will result in superior mean root coverage percentage, and root coverage esthetic score after 3-months.
Participants will:
- Come in for a first visit to check your gum health, check eligibility and to be provided with scaling and polishing if needed.
- Come in for surgery and clinical measurements.
- Participant will be asked to complete post-operative questionnaire for 14 days.
- Re-evaluated after 1 week and suture removal at 2 weeks.
- Follow-up after 1 and 3 months.
Read the detailed description
This split-moth pilot study is designed to assess the comparative effectiveness of V-reverse suturing technique(test) and anchored sling suturing technique (Control) in patients with bilateral multiple adjacent gingival recession. The primary aim of the study is to compare the test and control groups in terms of the obtained mean root coverage (mRC) and Root coverage esthetic score (RES) in 3 months. The secondary aims are to compare the two groups in terms of Complete root coverage (CRC), Keratinized tissue width (KTW), Gingival thickness (GT), Recession depth (REC), Probing depth (PD), and Patient-reported outcomes and satisfaction.
At surgery day (T0) baseline measurements and photographs will be taken for all participants and they will be treated with coronally advanced tunnel with autogenous connective tissue graft harvested from the palate for both sides. Each side will be randomly allocated for either V-reverse suturing technique (test) or anchored sling suturing technique (control) to advance the tunnel coronally. At the end of the surgery postoperative instructions will be delivered to all patients in a written and oral manner, in conjunction with a medical prescription, and post-operative questionnaire to fill for the next 14 days to capture patient-reported experience measures (PREMs).
Participants will be re-evaluated at 1 week and at 2 weeks sutures will be removed.
At (T1) 1 month after surgery the following parameters will be recorded : bleeding on probing (BOP), plaque index (PI), and recession depth.
At (T2) 3 month after surgery the following parameters will be recorded : bleeding on probing (BOP), plaque index (PI), recession depth, probing depth (PD), clinical attachment loss (CAL), gingival thickness (GT), keratinized tissue width (KTW), Root coverage esthetic score (RES), mean root coverage% (mRC%), and complete root coverage(cRC "YES/NO")..
Visual analog scale from 0 - 10 (10- very dissatisfied, 0- very satisfied) at each visit after surgery was taken to assess patients overall satisfaction, and another visual analog scale from 0 - 10 (10- worst pain, 0- no pain) to assess patients perceptions of pain.
Photographs will be taken at each visit, all indices will be recorded by a calibrated examiner, and oral hygiene instructions will be reinforced at each visit.
The trial will be conducted in accordance with the Declaration of Helsinki (2013) and Good Clinical Practice (GCP) guidelines. Approval has been granted by the Institutional Review Board (IRB) of Jordan University of Science and Technology. Written informed consent will be obtained from all participants prior to enrollment. Adverse events will be documented, monitored, and reported according to IRB requirements.
- Conditions
- Gingival Recession, Mucogingival Surgery
- Being tested
- coronally advanced tunnel with v-reverse suture, coronally advanced tunnel with anchored sling suture
- Keywords
- plaque index, Bleeding On Probing, Gingival Recession, Multiple Adjacent Gingival Recession, V-reverse suture, anchored sling suture, mean root coverage, root coverage esthetic score, complete root coverage, keratinized tissue width, gingival thickness, probing depth, recession depth, root coverage, coronally advanced tunnel, patient-reported experience measures, pilot study, split-mouth, gingiva, periodontium
- Medical subject headings
- Gingival Recession
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
coronally advanced tunnel with v-reverse sutureProcedure or surgery
The V-reverse suturing technique can be a valid technique for improving graft and flap stability in the midfacial region which is likely the most crucial area that should be firm for achieving complete root coverage following the tunnel approach.
The V-reverse suture starts in the palatal aspect, passing below the splinted contact point. Then the needle engages the graft and the flap (from inside to outside) ≈3 mm apical to the soft tissue margin in the mid-facial area. Then the needle passes to the palatal side under the contact point. Then the needle turns one round around the splinted composite (without pinching the soft tissue), and then the knot is performed and tightened over the composite. At the end, the sutures form a V-reverse shape
coronally advanced tunnel with anchored sling sutureProcedure or surgery
In addition to interrupted sutures, sling sutures have also regularly been applied as a conventional method of suturing to advance periodontal flaps over exposed root surfaces and connect the papillae to the interdental connective tissues, and composite stops where added to provide better stability.
| Study group | Role | What they receive |
|---|---|---|
| Test: V-Reverse Suture | Experimental | Coronally advanced tunnel with V-reverse suture. Receives: Procedure: coronally advanced tunnel with v-reverse suture |
| Control: Anchored Sling Suture | Active comparator | Coronally advanced tunnel with anchored sling suture Receives: Procedure: coronally advanced tunnel with anchored sling suture |
What is being measured
The primary outcome is the main question the study is designed to answer.
mean root coverage percentage
It represents the average percentage of the initial recession depth that has been successfully covered by new gum tissue over a defined period.
Measured: 3 months
root coverage esthetic score
(RES) is a, 10-point, five-variable system developed by Cairo et al. (2009) to objectively evaluate the success of gingival recession treatment. It evaluates root coverage (60% weight, 0-6 points) and four soft tissue parameters: margin contour, tissue texture, junction alignment, and color (40% weight, 1 point each).
Measured: 3 months
Secondary outcomes (8)
Percentage of complete root coverage
a periodontal surgical outcome where the gingival margin is repositioned to the level of, or coronal to, the cementoenamel junction (CEJ), completely covering previously exposed root surfaces
Measured: 3 months
change in keratinized tissue width
Measured as the distance from gingival margin to mucogingival junction (MGJ) using a periodontal probe (UNC15).
Measured: at baseline and 3 months
change in gingival thickness
Probe visibility technique was used, by inserting a periodontal probe (UNC15) in mid-facial aspect of the tooth, and thin gingival biotype is defined as ≤ 1mm (visible probe), while thick is > 1mm (invisible probe).
Measured: at baseline and at 3 months
change in recession depth
Measured as the distance between the cementoenamel junction (CEJ) and gingival margin using a periodontal probe (UNC15).
Measured: at baseline, 1 month, and 3 months
Patient reported experience measures (PREMs)
were assessed using validated translations of the OHIP-14 questionnaire into the native language of all participants. Patients were instructed to use a postoperative diary for the first 14 days after the surgery to capture patient-reported experience measures (PREMs). The diary was designed to assess patient recovery in four main areas: post-surgery sequelae, pain and discomfort, oral function, interference with daily activities.
Measured: For 14 days after surgery
change in probing depth
Measured as the distance from the gingival margin to the base of the pocket using a periodontal probe (UNC15).
Measured: at baseline and 3 months
Patient satisfaction score
Visual analog scale from 0 - 10 (10- very dissatisfied, 0- very satisfied) at each visit after surgery was taken to assess patients overall satisfaction.
Measured: day one, 1week, 2weeks, 1 month, 3months after surgery
Patient perception of pain score
Visual analog scale from 0 - 10 (10- worst pain, 0- no pain) to assess patients perceptions of pain.
Measured: day one, 1 week, 2 weeks following surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 May 2026
- Study start1 Apr 2025
- Primary completion23 Mar 2026
- Study completion1 Jun 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Gingival Recession, Mucogingival SurgeryStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- This study is conduct in a split mouth fashion, meaning each patient arch is divided into quadrants, each quadrant is then randomized to either the test or the control group. Therefore, the study is considered a parallel-group (within-subject) design in terms of participant recruitment, because each subject receives two experimental interventions. However, from an intervention and randomization perspective, it is a comparative trial where the mouth is divided into quadrants (e.g., left and right) that are randomly assigned to different suturing techniques.
- Masking
- Double blind
- Who is masked
- Participant, Care provider
- Enrolment
- 7 participants (actual)
Sponsor and investigators
- Lead sponsor
- King Abdullah University Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- Jordan University of Science and Technology, Deanship of Scientific Research/Jordan University of Science and Technology
- Responsible party
- Principal investigator, Reem Abdel-Hafez, Jordan University of Science and Technology
- Investigators
- Reem Abdel-Hafez, Study chair, Jordan University of Science and Technology
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07602829
- Sponsor's protocol ID
- 20240614
- Status last verified
- May 2026
- First submitted
- 3 May 2026
- Last updated
- 22 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: We plan to share de-identified individual participant data (IPD) including demographics, primary and secondary outcome measures, and adverse events. Data will be made available beginning 12 months after publication of the primary results, and will be accessible to qualified researchers upon reasonable request, subject to data-sharing agreements and IRB approval.
Study at a glance
From the registry record, last updated by the sponsor on 22 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Modified Coronally Advanced Tunnel for Root Coverage With Sling Suture VS. V-Reverse Suture: A Slit-Mouth Pilot Study
- ClinicalTrials.gov ID
- NCT07602829
- Acronym / sponsor ID
- 20240614
- Conditions
- Gingival Recession, Mucogingival Surgery
- Keywords
- plaque index, Bleeding On Probing, Gingival Recession, Multiple Adjacent Gingival Recession, V-reverse suture, anchored sling suture, mean root coverage, root coverage esthetic score
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 7 participants (actual)
- Lead sponsor
- King Abdullah University HospitalUniversity, hospital or other
- Collaborators
- Jordan University of Science and Technology, Deanship of Scientific Research/Jordan University of Science and Technology
- Study start
- 1 Apr 2025 (actual)
- Primary completion
- 23 Mar 2026 (actual)
- Study completion
- 1 Jun 2027 (estimated)
- First posted
- 22 May 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this split-mouth pilot study is to study the effect of two different suturing techniques in root coverage using coronally advanced flap tunnel in multiple adjacent recession cases to see which technique will give superior outcomes in term of mean root coverage percentage, and root coverage esthetic score after 3-months.
The main questions it aims to answer are:
- Does a suturing technique gives superior mean root coverage percentage over another?
- Does a suturing technique gives superior root coverage esthetic score?
Researcher will compare between V-reverse suturing technique and anchored sling suture to see which will result in superior mean root coverage percentage, and root coverage esthetic score after 3-months.
Participants will:
- Come in for a first visit to check your gum health, check eligibility and to be provided with scaling and polishing if needed.
- Come in for surgery and clinical measurements.
- Participant will be asked to complete post-operative questionnaire for 14 days.
- Re-evaluated after 1 week and suture removal at 2 weeks.
- Follow-up after 1 and 3 months.
Detailed description
This split-moth pilot study is designed to assess the comparative effectiveness of V-reverse suturing technique(test) and anchored sling suturing technique (Control) in patients with bilateral multiple adjacent gingival recession. The primary aim of the study is to compare the test and control groups in terms of the obtained mean root coverage (mRC) and Root coverage esthetic score (RES) in 3 months. The secondary aims are to compare the two groups in terms of Complete root coverage (CRC), Keratinized tissue width (KTW), Gingival thickness (GT), Recession depth (REC), Probing depth (PD), and Patient-reported outcomes and satisfaction.
At surgery day (T0) baseline measurements and photographs will be taken for all participants and they will be treated with coronally advanced tunnel with autogenous connective tissue graft harvested from the palate for both sides. Each side will be randomly allocated for either V-reverse suturing technique (test) or anchored sling suturing technique (control) to advance the tunnel coronally. At the end of the surgery postoperative instructions will be delivered to all patients in a written and oral manner, in conjunction with a medical prescription, and post-operative questionnaire to fill for the next 14 days to capture patient-reported experience measures (PREMs).
Participants will be re-evaluated at 1 week and at 2 weeks sutures will be removed.
At (T1) 1 month after surgery the following parameters will be recorded : bleeding on probing (BOP), plaque index (PI), and recession depth.
At (T2) 3 month after surgery the following parameters will be recorded : bleeding on probing (BOP), plaque index (PI), recession depth, probing depth (PD), clinical attachment loss (CAL), gingival thickness (GT), keratinized tissue width (KTW), Root coverage esthetic score (RES), mean root coverage% (mRC%), and complete root coverage(cRC "YES/NO")..
Visual analog scale from 0 - 10 (10- very dissatisfied, 0- very satisfied) at each visit after surgery was taken to assess patients overall satisfaction, and another visual analog scale from 0 - 10 (10- worst pain, 0- no pain) to assess patients perceptions of pain.
Photographs will be taken at each visit, all indices will be recorded by a calibrated examiner, and oral hygiene instructions will be reinforced at each visit.
The trial will be conducted in accordance with the Declaration of Helsinki (2013) and Good Clinical Practice (GCP) guidelines. Approval has been granted by the Institutional Review Board (IRB) of Jordan University of Science and Technology. Written informed consent will be obtained from all participants prior to enrollment. Adverse events will be documented, monitored, and reported according to IRB requirements.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, care provider)
- Number of arms
- 2
- Model description
- This study is conduct in a split mouth fashion, meaning each patient arch is divided into quadrants, each quadrant is then randomized to either the test or the control group. Therefore, the study is considered a parallel-group (within-subject) design in terms of participant recruitment, because each subject receives two experimental interventions. However, from an intervention and randomization perspective, it is a comparative trial where the mouth is divided into quadrants (e.g., left and right) that are randomly assigned to different suturing techniques.
| Arm | Type | Receives |
|---|---|---|
| Test: V-Reverse Suture | Experimental | Procedure: coronally advanced tunnel with v-reverse sutureCoronally advanced tunnel with V-reverse suture. |
| Control: Anchored Sling Suture | Active comparator | Procedure: coronally advanced tunnel with anchored sling sutureCoronally advanced tunnel with anchored sling suture |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Age ≥ 18 years
- Periodontally and systemically healthy;
- Good plaque control (FMPS < 20%)
- Presence of two quadrants exhibiting multiple (2 or more sites) adjacent RT1 or RT2 gingival recession ≥ 2 mm in at least one site.
- Non-smoker.
Key exclusion criteria (10 listed)
- Smoking
- Pregnant or lactating women;
- Untreated periodontitis;
- Systemic disorders with compromised healing potential;
- Use of medications (immuno-suppressants, phenytoin, or anything else that might affect soft tissue healing);
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| coronally advanced tunnel with v-reverse sutureThe V-reverse suturing technique can be a valid technique for improving graft and flap stability in the midfacial region which is likely the most crucial area that should be firm for achieving complete root coverage following the tunnel approach. The V-reverse suture starts in the palatal aspect, passing below the splinted contact point. Then the needle engages the graft and the flap (from inside to outside) ≈3 mm apical to the soft tissue margin in the mid-facial area. Then the needle passes to the palatal side under the contact point. Then the needle turns one round around the splinted composite (without pinching the soft tissue), and then the knot is performed and tightened over the composite. At the end, the sutures form a V-reverse shape | Procedure or surgery | Test: V-Reverse Suture |
| coronally advanced tunnel with anchored sling sutureIn addition to interrupted sutures, sling sutures have also regularly been applied as a conventional method of suturing to advance periodontal flaps over exposed root surfaces and connect the papillae to the interdental connective tissues, and composite stops where added to provide better stability. | Procedure or surgery | Control: Anchored Sling Suture |
Primary outcome
mean root coverage percentage
Time frame: 3 months
It represents the average percentage of the initial recession depth that has been successfully covered by new gum tissue over a defined period.
root coverage esthetic score
Time frame: 3 months
(RES) is a, 10-point, five-variable system developed by Cairo et al. (2009) to objectively evaluate the success of gingival recession treatment. It evaluates root coverage (60% weight, 0-6 points) and four soft tissue parameters: margin contour, tissue texture, junction alignment, and color (40% weight, 1 point each).
8 secondary outcomes
Percentage of complete root coverage
Time frame: 3 months
change in keratinized tissue width
Time frame: at baseline and 3 months
change in gingival thickness
Time frame: at baseline and at 3 months
change in recession depth
Time frame: at baseline, 1 month, and 3 months
Patient reported experience measures (PREMs)
Time frame: For 14 days after surgery
change in probing depth
Time frame: at baseline and 3 months
Patient satisfaction score
Time frame: day one, 1week, 2weeks, 1 month, 3months after surgery
Patient perception of pain score
Time frame: day one, 1 week, 2 weeks following surgery
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 May 2026.
- Individual participant dataSharing planned: Yes. We plan to share de-identified individual participant data (IPD) including demographics, primary and secondary outcome measures, and adverse events. Data will be made available beginning 12 months after publication of the primary results, and will be accessible to qualified researchers upon reasonable request, subject to data-sharing agreements and IRB approval.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Reem Abdel-Hafez study chair
Jordan University of Science and Technology
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing coronally advanced tunnel with v-reverse suture and coronally advanced tunnel with anchored sling suture in people with Gingival Recession, Mucogingival Surgery, run by King Abdullah University Hospital at 1 site in Jordan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 22 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Jordan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
mean root coverage percentage (time frame: 3 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 May 2026.