Clinical evaluation of root coverage by sub-epithelial connective tissue graft with and without odontoplasty in treatment of teeth with cervical abrasion

ABSTRACT

No clinical trial has been done in relation to successful coverage of gingival recessions with and without odontoplasty. This study was designed to evaluate the effects of odontoplasty with subepithelial connective tissue graft [SeCTG] on the outcome of root coverage on abraded teeth with gingival recessions, attachment level, height of keratinized gingival and teeth sensitivity. Thirty-six class I, and III Miller recessions were treated in 10 patients, using SeCTG with coronally positioned flap with [test group] and without [control group] odontoplasty. Clinical measurements probing depth, abrasion depth, height of recession [HR], width of recession [WR], height of keratinized gingival [KG], clinical attachment level [CAL], width of interdental papilla, bone level and vestibule depth were recorded at base line and 3 months after surgery. The changes in variables were evaluated by paired t test and Wilcoxon's sign ranked test. Probing depth before and after surgery was reduced 0.44 mm in the test group which was not statistically significant. However the difference was significant in the control group [P=0.007]. Differences between mean clinical attachment level [CAL], height of recession [HR], width of recession [WR] and height of keratinized gingival [KG] in test and control groups before and after surgery were statistically significant [P<0.0001]. Differences between the two groups in CAL, and HR were statistically significant [P=0.026, P=0.03]. Difference between mean two groups in KG before surgery was statistically significant [P=0.036]. However difference between two groups was not statistically significant. Difference between before and after surgery in vestibule depth was not statistically significant. Interdental papilla in test group had not any relation with mean root coverage, however in control group the relation was highly significant [P=0.001, r=0.75]. Bone level in mid facial in both groups had not significant relation with mean root coverage. Abrasion depth in test group had not significant relation with mean root coverage. However, in control group, had significant relation with mean root coverage [p=0.003, r =0.65]. SeCTG with coronally positioned flap is a predictable method for root coverage with shallow, moderate and deep recessions. Odontoplasty in abraded teeth in order to decrease avascular surfaces, irregularities and root convexity results in better clinical outcome to gain clinical attachment, root coverage and keratinized gingiva