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Root coverage using the coronally positioned flap with or without a subepithelial connective tissue graft.
Robert Carvalho da Silva1, Julio César Joly, Antonio Fernando Martorelli de Lima
1Department of Prosthodontics and Periodontics, School of Dentistry at Piracicaba, University of Campinas, São Paulo, Brazil. dasilvarc@fop.unicamp.br
Journal of Periodontology
|April 20, 2004
Summary
Both coronally positioned flap (CPF) alone and with subepithelial connective tissue graft (SCTG) effectively treat gingival recession. The combined technique enhances gingival dimensions, offering superior results for root coverage and tissue augmentation.
Area of Science:
- Periodontology
- Oral Surgery
- Regenerative Dentistry
Background:
- Gingival recession is a common condition requiring surgical intervention.
- Various techniques exist, including coronally positioned flap (CPF) and subepithelial connective tissue graft (SCTG).
- This study compares CPF alone versus CPF with SCTG for treating Miller Class I recession defects.
Purpose of the Study:
- To compare the efficacy of coronally positioned flap (CPF) alone versus CPF with subepithelial connective tissue graft (SCTG) in treating gingival recession.
- To evaluate root coverage, probing depth, clinical attachment level, keratinized tissue width, and gingival thickness.
- To determine if combined techniques offer additional benefits in gingival dimension increase.
Main Methods:
- Randomized clinical trial involving 11 non-smoking subjects with bilateral Miller Class I recession defects.
- Defects were randomly assigned to test (CPF + SCTG) or control (CPF alone) groups.
- Measurements included recession depth, probing depth, clinical attachment level, keratinized tissue width, and gingival thickness at baseline and 6 months.
Main Results:
- Both groups showed significant reduction in recession depth and effective root coverage (75% test, 69% control).
- No significant differences were observed between groups for recession depth, probing depth, or clinical attachment level.
- The CPF + SCTG group demonstrated a statistically significant increase in keratinized tissue width and gingival thickness compared to the CPF alone group.
Conclusions:
- Both surgical techniques effectively achieve root coverage for gingival recession.
- The combined CPF + SCTG technique is recommended when increasing gingival dimensions (keratinized tissue width, gingival thickness) is a primary treatment goal.
- Subepithelial connective tissue grafting enhances soft tissue volume in conjunction with root coverage procedures.