The subepithelial connective tissue graft: part II. Histologic healing and clinical root coverage

Area of Science:

• Periodontology
• Periodontal Plastic Surgery
• Regenerative Dentistry

Background:

• Periodontal plastic surgery techniques aim to cover exposed root surfaces, addressing patient aesthetic and sensitivity concerns.
• Various surgical methods exist, including free gingival grafts (FGGs), pedicle flaps, subepithelial connective tissue grafts (SCTGs), acellular dermal matrix (ADM) grafts, and guided tissue regeneration (GTR).

Purpose of the Study:

• To evaluate the efficacy and predictability of different periodontal plastic surgical techniques for root coverage.
• To identify the current treatment of choice for achieving successful root coverage.

Main Methods:

• Review and comparison of outcomes from studies utilizing FGGs, pedicle flaps, SCTGs, ADM grafts, and GTR for root coverage.
• Analysis of reported success rates and limitations associated with each technique.

Main Results:

• Free gingival grafts (FGGs) show inconsistent results for root coverage.
• Pedicle flaps provide consistent results when adequate tissue is available initially.
• Acellular dermal matrix (ADM) grafts show success but may have long-term stability issues.
• Subepithelial connective tissue grafts (SCTGs) and guided tissue regeneration (GTR) demonstrate high predictability.
• Average root coverage rates for SCTGs and GTR are reported as 98.9% and 92.3%, respectively.

Conclusions:

• Subepithelial connective tissue grafts (SCTGs) and guided tissue regeneration (GTR) are currently considered the most predictable and effective treatments for periodontal root coverage.
• These techniques offer superior outcomes compared to FGGs, pedicle flaps, and ADM grafts for achieving significant root surface coverage.