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Flap thickness as a predictor of root coverage: a systematic review
1Graduate Periodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
Journal of Periodontology
|October 13, 2006
Summary
Thicker gingival flaps are associated with better root coverage outcomes in periodontal surgery. A flap thickness greater than 1.1 mm appears critical for achieving significant mean and complete root coverage, especially with connective tissue grafting.
Area of Science:
- Periodontal Plastic Surgery
- Regenerative Dentistry
Background:
- Thick gingival tissue offers surgical advantages like improved handling, maintained vascularity, and enhanced wound healing.
- Emerging evidence suggests a link between increased flap thickness and superior root coverage in treating gingival recession defects.
Purpose of the Study:
- To systematically review and analyze existing literature on the relationship between gingival flap thickness and root coverage outcomes.
- To determine if gingival thickness is a significant factor in achieving successful root coverage after periodontal therapy.
Main Methods:
- A systematic review of human studies reporting recession details, flap thickness measurements, root coverage procedures, and follow-up of at least 3 months.
- Methodological quality was assessed, and data on weighted gingival thickness and root coverage were statistically analyzed using Mann-Whitney, ANOVA, and regression.
- Correlation between thickness, treatment type, and follow-up duration with root coverage was investigated.
Main Results:
- Fifteen studies met inclusion criteria, all reporting flap thickness ≥0.7 mm.
- A moderate positive correlation was found between flap thickness and both mean and complete root coverage (r=0.646 and r=0.454).
- A critical threshold of >1.1 mm flap thickness was identified for significant root coverage (P<0.02), with stronger correlations in connective tissue grafting and guided tissue regeneration.
Conclusions:
- A positive association exists between increased gingival flap thickness and improved mean and complete root coverage.
- Gingival flap thickness is a significant factor influencing the success of root coverage procedures, particularly with specific graft types.
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