Long-Term Stability of Root Coverage by Coronally Advanced Flap Procedures

Area of Science:

• Periodontology
• Regenerative Dentistry

Background:

• Localized gingival recessions are common, impacting aesthetics and tooth sensitivity.
• Coronally advanced flap (CAF) is a surgical technique for root coverage (RC).
• The long-term stability of CAF outcomes, with or without xenogeneic collagen matrix (CMX), requires further investigation.

Purpose of the Study:

• To compare 6-month and 3-year outcomes for root coverage (RC) using coronally advanced flap (CAF) procedures.
• To assess the predictability of short-term RC outcomes for long-term results in localized gingival recessions.
• To evaluate the stability of keratinized tissue dimensions following CAF procedures.

Main Methods:

• A 3-year follow-up of 18 patients with 36 Miller Class I and II defects previously treated in a 6-month randomized clinical trial (RCT).
• Split-mouth design comparing CAF alone versus CAF with xenogeneic collagen matrix (CMX).
• Assessment of percentage of root coverage (RC), complete root coverage (CRC), and keratinized tissue dimensions by masked examiners.

Main Results:

• High correlation observed between 6-month and 3-year RC outcomes for both CAF and CAF + CMX (Pearson's correlation: 0.91-0.94).
• Mean RC was 89.9% at 6 months and 91.7% at 3 years for CAF + CMX; 83.7% at 6 months and 82.8% at 3 years for CAF.
• Complete root coverage (CRC) remained stable: 61% for CAF + CMX and 39% for CAF at both time points.

Conclusions:

• Root coverage outcomes following CAF procedures are stable between 6 months and 3 years.
• Six-month RC results can effectively predict long-term outcomes for CAF procedures, with or without CMX.
• The use of CMX does not significantly alter the long-term stability of root coverage outcomes.