A 3-year longitudinal evaluation of subpedicle free connective tissue graft for gingival recession coverage

The purpose of this study was to longitudinally evaluate, over a 3-year period, the reduction of gingival recession through use of a subepithelial free connective tissue graft placed under a coronally advanced partial-thickness pedicle flap.

Twenty-one buccal recession defects (mean 3.67 mm; range 3 to 4.5 mm; Miller Class I, II, and III) in 15 patients were treated using this technique. Amount of gingival recession (GR), clinical attachment loss (CAL), and width of keratinized gingiva (WKG) were followed for 3 years after surgery. The measurements were performed at presurgery, and 1, 3, 6, 12, 18, 24, and 36 months postsurgery.

GR decreased from 3.67 +/- 0.58 mm at baseline to 0.33 +/- 0.43 mm at 36 months, representing a reduction of 3.33 mm, corresponding to 91.28% mean root coverage. CAL was significantly decreased at 36 months from 5.26 +/- 0.77 mm to 2.14 +/- 0.57 mm. At 36 months, 3.12 mm of attachment gain was obtained. WKG significantly increased after 36 months (1.95 mm). GR, CAL, and WKG had the most positive outcomes at 12 months and were maintained at stable levels throughout the 36-month observation period.

These results indicate that the connective tissue graft with a partial thickness coronal advancement pedicle is a predictable method for root coverage and, provided that optimal maintenance care is provided, the clinical outcomes gained by this technique can be well maintained.