{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T08:46:58Z","timestamp":1791708418042,"version":"4.3.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Suzhou Municipal Science and Technology Key Research General Project","award":["Grant No. SYW2025082"],"award-info":[{"award-number":["Grant No. SYW2025082"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare connective tissue graft with thick and thin acellular dermal matrices in a modified vestibular incision subperiosteal tunnel access\u2013based procedure, using gingival thickness at the selected target site 18 months postoperatively as the primary endpoint.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-center exploratory randomized trial, 36 adults with recession type 1 gingival recession were allocated in a 1:1:1 ratio to connective tissue graft, thick acellular dermal matrices (1.0\u20131.2\u2005mm), and thin acellular dermal matrices (0.4\u20130.6\u2005mm) groups. Longitudinal continuous outcomes were analyzed using linear mixed models. Pairwise comparisions at 18 months were performed using Welch tests with within-outcome Bonferroni adjustment. Postoperative visual analogue scale pain scores and Landry healing scores were analyzed nonparametrically. Missing-data scenarios and two one-sided tests were post hoc.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 47 individuals assessed, 11 were excluded and 36 were randomized (12 per group); 18-month primary-endpoint data were available for 35 patients. The mean (SD) gingival thickness was 1.708 (0.334) mm in the connective tissue graft group, 1.708 (0.450) mm in the thick acellular dermal matrices group, and 1.273 (0.410) mm in the thin acellular dermal matrices group. The mean gingival thickness in the connective tissue graft group exceeded that in the thin acellular dermal matrices group by 0.436\u2005mm (95% confidence interval: 0.108 to 0.763; adjusted\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.036); the difference in the gingival thickness between the thick acellular dermal matrices and thin acellular dermal matrices groups was not statistically significant after adjustment (adjusted\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.073). Connective tissue graft and thick acellular dermal matrices groups had comparable observed means; however, the trial was not powered for equivalence. Postoperative visual analog scale scores were lower in both acellular dermal matrices groups than in the connective tissue graft group, and thin acellular dermal matrices group had a higher day-7 healing score than the thick acellular dermal matrices group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The 18-month gingival thickness was greater in the connective tissue graft group than in the thin acellular dermal matrices group after multiplicity adjustment, whereas the mean values of the connective tissue graft and thick acellular dermal matrices groups were comparable. The study did not establish equivalence, and the root-coverage estimates were too imprecise to demonstrate comparability. Acellular dermal matrices avoided palatal donor-site harvesting and were associated with lower postoperative visual analog scale pain scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Chinese Clinical Trial Registry (WHO Primary Registry), ChiCTR2600124861.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605261495779","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T02:01:06Z","timestamp":1791424866000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of connective tissue graft using two acellular dermal matrix thicknesses in a modified vestibular incision subperiosteal tunnel access\u2013based procedure for gingival recession: An exploratory randomized controlled trial"],"prefix":"10.1177","volume":"54","author":[{"given":"Peisen","family":"Li","sequence":"first","affiliation":[{"name":"Department of Periodontology, Suzhou Stomatological Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Suzhou Stomatological Hospital, China"},{"name":"Suzhou Red Cross Dental Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuehan","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Suzhou Stomatological Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianqing","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Suzhou Stomatological Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingyun","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Suzhou Stomatological Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9130-2349","authenticated-orcid":false,"given":"Xingru","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Suzhou Stomatological Hospital, China"},{"name":"Suzhou Red Cross Dental Hospital, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2003.0137"},{"key":"e_1_3_3_3_2","first-page":"653","article-title":"Minimally invasive treatment of maxillary anterior gingival recession defects by vestibular incision subperiosteal tunnel access and platelet-derived growth factor BB","volume":"31","author":"Zadeh HH","year":"2011","unstructured":"Zadeh HH. Minimally invasive treatment of maxillary anterior gingival recession defects by vestibular incision subperiosteal tunnel access and platelet-derived growth factor BB. Int J Periodontics Restorative Dent 2011; 31: 653\u2013660.","journal-title":"Int J Periodontics Restorative Dent"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-022-04746-w"},{"key":"e_1_3_3_5_2","first-page":"80","article-title":"Vestibular incision subperiosteal tunnel access with connective tissue graft for the treatment of Miller class I and II gingival recession]","volume":"51","author":"Fan K","year":"2019","unstructured":"Fan K, Zhong JS, Ouyang XY, et al. [Vestibular incision subperiosteal tunnel access with connective tissue graft for the treatment of Miller class I and II gingival recession]. Beijing Da Xue Xue Bao Yi Xue Ban 2019; 51: 80\u201385.","journal-title":"Beijing Da Xue Xue Bao Yi Xue Ban"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/jerd.12434"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.11607\/prd.6135"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-023-05383-7"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.19-0350"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1985.56.12.715"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2002.73.12.1405"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/app14135614"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.34172\/japid.2020.004"},{"key":"e_1_3_3_14_2","article-title":"Clinical applications of acellular dermal matrices: a review","volume":"8","author":"Petrie K","year":"2022","unstructured":"Petrie K, Cox CT, Becker BC, et al. Clinical applications of acellular dermal matrices: a review. Scars Burn Heal 2022; 8: 20595131211038313.","journal-title":"Scars Burn Heal"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2015.130674"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12182"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.19-0079"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.19-0351"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12446"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/cap.10333"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-025-06913-3"},{"key":"e_1_3_3_22_2","article-title":"CONSORT 2025 Statement: updated guideline for reporting randomised trials","volume":"389","author":"Hopewell S","year":"2025","unstructured":"Hopewell S, Chan AW, Collins GS, et al. CONSORT 2025 Statement: updated guideline for reporting randomised trials. BMJ 2025; 389: e081123.","journal-title":"BMJ"},{"key":"e_1_3_3_23_2","first-page":"575","article-title":"Histologic evaluation of connective tissue grafts in humans","volume":"23","author":"Harris RJ","year":"2003","unstructured":"Harris RJ. Histologic evaluation of connective tissue grafts in humans. Int J Periodontics Restorative Dent 2003; 23: 575\u2013583.","journal-title":"Int J Periodontics Restorative Dent"},{"key":"e_1_3_3_24_2","first-page":"105","article-title":"Effectiveness of benzydamine HCl in the treatment of periodontal post-surgical patients","volume":"10","author":"Landry RG","year":"1988","unstructured":"Landry RG. Effectiveness of benzydamine HCl in the treatment of periodontal post-surgical patients. Res Clin Forums 1988; 10: 105\u2013118.","journal-title":"Res Clin Forums"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-34123-y"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-021-03879-8"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.21037\/apm-22-656"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.4103\/jisp.jisp_222_17"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.11607\/prd.5522"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-018-2470-6"},{"key":"e_1_3_3_31_2","first-page":"278","article-title":"Acellular dermal matrix allograft versus autogenous connective tissue grafts for thickening soft tissue and covering multiple gingival recessions: a 5-year preference clinical study","volume":"50","author":"Kroiss S","year":"2019","unstructured":"Kroiss S, Rathe F, Sader R, et al. Acellular dermal matrix allograft versus autogenous connective tissue grafts for thickening soft tissue and covering multiple gingival recessions: a 5-year preference clinical study. Quintessence Int 2019; 50: 278\u2013285.","journal-title":"Quintessence Int"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2005.76.2.178"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12935"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-025-06394-4"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.11607\/prd.2952"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.3390\/dj9030034"}],"container-title":["Journal of International Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03000605261495779","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03000605261495779","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03000605261495779","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T08:22:24Z","timestamp":1791706944000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03000605261495779"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":35,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1177\/03000605261495779"],"URL":"https:\/\/doi.org\/10.1177\/03000605261495779","relation":{},"ISSN":["0300-0605","1473-2300"],"issn-type":[{"value":"0300-0605","type":"print"},{"value":"1473-2300","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"article-number":"03000605261495779"}}