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It has been used in various surgical techniques, such as closing oroantral and oronasal communications and repairing defects due to trauma or malignancy. A few years ago, the buccal fat pad was utilized as a pedicle or free soft tissue graft to treat gingival recessions. Therefore, this randomized clinical trial (RCT) was conducted to assess the effectiveness of the free buccal fat pad graft (FBPFG) compared to the de-epithelialized free gingival graft (DFGG) in conjunction with coronally advanced flap (CAF) in localized gingival recession treatment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>This RCT included 39 participants, with 20 patients receiving a coronally advanced flap (CAF) with FBPFG (Group I) and 19 patients treated with CAF and DFGG (Group II). Clinical parameters such as probing depth (PD), clinical attachment level (CAL), recession depth (RD), width of keratinized gingiva (WKG), and gingival thickness (GT) were assessed after 3- and 6\u00a0months of surgical intervention.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>After 3- and 6-month follow-ups, statistically significant changes were noted between the groups in all clinical parameters. At 1st and 2nd days of surgical intervention, there was a statistically significant decrease in the values of the visual analogue scale (VAS) in group I compared to group II. Regarding dentinal hypersensitivity, there were statistically significant variations of 3- and 6-month parameters compared to baseline in the two groups. However, there were no differences between the two after the therapy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>It was proven that DFGG produces significantly better outcomes than FBPFG in treating localized gingival recession. However, FBPFG might serve as a viable alternative for mild to moderate gingival recession cases, where only a limited reduction in recession depth and modest increase in gingival thickness and width of keratinized tissues are required, with the benefit of lower donor site morbidity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration<\/jats:title>\n            <jats:p>This randomized controlled clinical trial was registered on the Pan African Clinical Trials Registry and approved on 22\/06\/2023 (Trial no: PACTR202307891237031).<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12903-025-06150-8","type":"journal-article","created":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T04:27:25Z","timestamp":1748060845000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The use of free buccal pad fat graft as a viable therapeutic modality in localized gingival recession: a randomized controlled clinical trial"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8046-5120","authenticated-orcid":false,"given":"Reham","family":"Abdel-Fatah","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayman","family":"Elkashty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hesham","family":"El-Sharkawy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,5,24]]},"reference":[{"issue":"3","key":"6150_CR1","doi-asserted-by":"publisher","first-page":"29","DOI":"10.3390\/dj9030029","volume":"9","author":"A Pilloni","year":"2021","unstructured":"Pilloni A, Marini L, Zeza B, Ferlosio A, Aghazada R. 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The research protocol was reviewed and approved by the Research Ethics Committee of the Faculty of Dentistry, Mansoura University, Egypt (Approval Number: M0306023OM). All procedures involving human participants followed the ethical standards set by the institutional research committee and the principles outlined in the 1964 Helsinki Declaration and its subsequent amendments or equivalent ethical standards. Informed consent was acquired from all participants involved in the study (provided as a supplementary file).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"<!--Emphasis Type='Bold' removed-->Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"780"}}