Periodontal Soft Tissue Root Coverage Procedures: Practical Applications From the AAP Regeneration Workshop.

Area of Science:

• Periodontology
• Oral Surgery

Background:

• Gingival recession (GR) defects present a common clinical challenge.
• Effective management aims for complete root coverage and improved periodontal health.

Purpose of the Study:

• To illustrate the management of gingival recession defects.
• To achieve complete root coverage as a primary outcome.

Main Methods:

• Review of current evidence and clinical consensus on GR defect management.
• Application of various surgical techniques including subepithelial connective tissue grafts (SCTG), coronally advanced flaps, free gingival grafts, and soft tissue substitutes.
• Consideration of biologics like recombinant human platelet-derived growth factor and enamel matrix derivative.

Main Results:

• Subepithelial connective tissue graft (SCTG)-based procedures demonstrate superior outcomes for mean and complete root coverage.
• Successful root coverage is associated with reduced defect depth, increased clinical attachment, and enhanced keratinized tissue (KT).
• Variability in techniques exists, particularly regarding palatal donor grafts.

Conclusions:

• Root coverage for gingival recession defects can be predictably achieved and maintained long-term.
• Subepithelial connective tissue grafts are evidence-based for optimal root coverage outcomes.
• Patient-reported outcomes require further research but should be considered in treatment decisions.