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Full-Endoscopic Interlaminar Approach for Decompression of Lateral Recess Stenosis
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Root coverage procedures for treating localised and multiple recession-type defects.

Leandro Chambrone1, Maria Aparecida Salinas Ortega, Flávia Sukekava

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This summary is machine-generated.

Subepithelial connective tissue grafts combined with coronally advanced flaps offer superior gingival recession reduction and keratinized tissue gain compared to other procedures. Further research is needed to clarify prognostic factors and the impact of bias in root coverage periodontal plastic surgery.

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Area of Science:

  • Periodontology
  • Regenerative Medicine
  • Dental Aesthetics

Background:

  • Gingival recession, characterized by apical displacement of the gingival margin, negatively impacts dental aesthetics.
  • Root coverage periodontal plastic surgery (RCPPS) procedures are crucial for successful treatment of recession-type defects.
  • This review updates a previous version from 2009, reflecting advancements in RCPPS.

Purpose of the Study:

  • To evaluate the effectiveness of various root coverage procedures for treating single and multiple gingival recession defects.
  • To compare the outcomes of different RCPPS techniques based on available randomized controlled trials.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) with a minimum 6-month duration.
  • Searched multiple databases (Cochrane Oral Health's Trials Register, CENTRAL, MEDLINE, Embase) up to January 2018.
  • Included RCTs evaluating Miller's Class I or II recession areas (≥ 3 mm) treated with RCPPS procedures.

Main Results:

  • Subepithelial connective tissue grafts (SCTG) + coronally advanced flap (CAF) showed greater recession reduction than guided tissue regeneration (GTR) with resorbable membranes + CAF (low-quality evidence).
  • SCTG + CAF also resulted in greater keratinized tissue gains compared to enamel matrix protein (EMP) + CAF and GTR rm + CAF (low to very low-quality evidence).
  • Insufficient evidence existed to differentiate outcomes between acellular dermal matrix grafts (ADMG) + CAF and SCTG + CAF for recession reduction or clinical attachment level changes.

Conclusions:

  • SCTG + CAF and GTR with resorbable membranes are viable options for treating localized or multiple recession defects.
  • SCTG + CAF demonstrates a slight advantage for combined root coverage and keratinized tissue gain.
  • Further RCTs are necessary to identify prognostic factors and the influence of bias on RCPPS outcomes.