{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:10:42Z","timestamp":1789495842765,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,5,14]],"date-time":"2014-05-14T00:00:00Z","timestamp":1400025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clinic Periodontology"],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this randomized clinical trial (<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>) was to compare the clinical performance of the tunnel technique with subepithelial connective tissue graft (<jats:styled-content style=\"fixed-case\">TUN<\/jats:styled-content>) <jats:italic>versus<\/jats:italic> a coronally advanced flap with enamel matrix derivative (<jats:styled-content style=\"fixed-case\">CAF<\/jats:styled-content>) in the treatment of gingival recession defects. The use of innovative 3D digital measuring methods allowed to study healing dynamics at connective tissue (<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>)\u2010grafted sites and to evaluate the influence of the thickness of the root covering soft tissues on the outcome of surgical root coverage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material &amp; Methods<\/jats:title><jats:p>Twenty\u2010four patients contributed a total of 47 Miller class I or <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> recessions for scientific evaluation. Precise study models collected at baseline and follow\u2010up examinations were optically scanned and virtually superimposed for digital evaluation of clinical outcome measures including mean marginal soft tissue thickness (<jats:styled-content style=\"fixed-case\">THK<\/jats:styled-content>). Healing dynamics were measured in a defined region of interest at <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>\u2010grafted sites where volume differences between time points were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 12\u00a0months, recession reduction as well as mean root coverage were significantly better at <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>\u2010grafted sites treated in the <jats:styled-content style=\"fixed-case\">TUN<\/jats:styled-content> group (1.94\u00a0mm and 98.4% respectively) compared to the non\u2010augmented sites of the <jats:styled-content style=\"fixed-case\">CAF<\/jats:styled-content> group (1.17\u00a0mm and 71.8% respectively) and statistical analysis revealed a positive correlation of <jats:styled-content style=\"fixed-case\">THK<\/jats:styled-content> (1.63\u00a0mm <jats:styled-content style=\"fixed-case\">TUN <\/jats:styled-content><jats:italic>versus<\/jats:italic> 0.91\u00a0mm <jats:styled-content style=\"fixed-case\">CAF<\/jats:styled-content>,<jats:italic> p\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.0001) to both these variables. Soft tissue healing following surgical root coverage with <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>\u2010grafting was mainly accomplished after 6\u00a0months, with around two\u2010thirds of the augmented volume being maintained after 12\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">TUN<\/jats:styled-content> resulted in thicker gingiva and better clinical outcomes compared to <jats:styled-content style=\"fixed-case\">CAF<\/jats:styled-content>. Increased gingival thickness was associated with better surgical outcomes in terms of recession reduction and root coverage.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jcpe.12254","type":"journal-article","created":{"date-parts":[[2014,4,7]],"date-time":"2014-04-07T13:22:40Z","timestamp":1396876960000},"page":"593-603","source":"Crossref","is-referenced-by-count":98,"title":["Tunnel technique with connective tissue graft <i>versus<\/i> coronally advanced flap with enamel matrix derivative for root coverage: a <scp>RCT<\/scp> using 3D digital measuring methods. Part <scp>II<\/scp>. Volumetric studies on healing dynamics and gingival dimensions"],"prefix":"10.1111","volume":"41","author":[{"given":"Stephan F.","family":"Rebele","sequence":"first","affiliation":[{"name":"Private Office Huerzeler\/Zuhr Munich Germany"},{"name":"Department of Operative Dentistry and Periodontology University School of Dentistry Albert\u2010Ludwigs\u2010University Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otto","family":"Zuhr","sequence":"additional","affiliation":[{"name":"Private Office Huerzeler\/Zuhr Munich Germany"},{"name":"Department of Periodontology Center for Dental, Oral and Maxillofacial Medicine (Carolinum) Johann Wolfgang Goethe University Frankfurt\/Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Schneider","sequence":"additional","affiliation":[{"name":"Clinic of Fixed and Removable Prosthodontics and Dental Material Science Center of Dental Medicine University of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronny E.","family":"Jung","sequence":"additional","affiliation":[{"name":"Clinic of Fixed and Removable Prosthodontics and Dental Material Science Center of Dental Medicine University of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus B.","family":"H\u00fcrzeler","sequence":"additional","affiliation":[{"name":"Private Office Huerzeler\/Zuhr Munich Germany"},{"name":"Department of Operative Dentistry and Periodontology University School of Dentistry Albert\u2010Ludwigs\u2010University Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,5,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2009.090122"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12211"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1999.70.9.1077"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2008.01267.x"},{"key":"e_1_2_6_6_1","first-page":"59","article-title":"Healing of gingival recessions using a collagen membrane with a hemineralized xenograft: a randomized controlled clinical trial","volume":"29","author":"Cardaropoli D.","year":"2009","journal-title":"International Journal of Periodontics Restorative Dentistry"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2011.110215"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2008.05.007"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2010.090540"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0757.2011.00434.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2008.01346.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1996.tb00621.x"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2009.01381.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2006.060107"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12019"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2011.110143"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2012.110373"},{"key":"e_1_2_6_18_1","first-page":"8","article-title":"A classification of marginal tissue recession","volume":"5","author":"Miller P. 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