Microsurgical treatment of gingival recession: a controlled clinical study

When maximum precision is required in performing surgery to satisfy particular esthetic demands, a surgical microscope that enhances complete visualization of the operative field may represent a useful tool. Twenty-four cases of gingival recession (depth 2 to 5 mm) were treated by different mucogingival surgical techniques in 24 patients: 12 procedures were performed with the aid of a surgical microscope (test group), whereas the other 12 patients were treated without the microscope (control group). Recession depth, probing depth, periodontal attachment loss, and keratinized gingival tissue width were recorded at baseline and 12 months following surgery. Three examiners separately evaluated pictures of the final cases on a scale from 1 to 3, focusing on three esthetic parameters (scarring, gingival margin, and papillae appearance). All parameters significantly improved from baseline to 12 months in both groups, except for probing depth, which did not significantly change. Although the outcomes of the test group always showed a major improvement over the controls, no significant differences could be detected between test and control groups. Mean defect coverage at 12 months was 86% and 78% for test and control groups, respectively; complete coverage was achieved in 58.3% and 33.4% of cases, respectively. Qualitative esthetic evaluation showed: (1) high concurrence among examiners; (2) significantly better scarring and marginal profile in the test group; and (3) no significant difference in papillae appearance. The application of magnification in mucogingival surgery accomplished better results in terms of success and predictability compared to conventional techniques and might help achieve excellent esthetic outcomes.