Root coverage in isolated gingival recessions using autograft versus allograft: a pilot study.

BACKGROUND: Different surgical techniques have been used to treat gingival recessions. This preliminary study compared clinical findings for the treatment of isolated gingival defects using a coronally positioned flap associated with a subepithelial connective tissue graft or an acellular dermal matrix graft. METHODS: Ten subjects with bilateral and comparable Miller Class I or II defects were selected. The defects were > or =3.0 mm deep and were assigned randomly to the test group, which was treated with a coronally positioned flap associated with an acellular dermal matrix, or to the control group, which was treated with a coronally positioned flap associated with a subepithelial connective tissue graft. Probing depth (PD), clinical attachment level (CAL), gingival recession depth (GRD), and width (KT) and thickness (GT) of the keratinized tissue were assessed at baseline and 6 months after the surgery. RESULTS: Mean root coverage was 50% in the test group (representing a gingival margin shift of 2.1 +/- 0.99 mm) and 79.5% in the control group (representing a gingival margin shift of 3.5 +/- 1.20 mm). These results were statistically different on intra- and intergroup comparisons (P <0.05). Between-group comparisons revealed statistically significantly greater gains in CAL, GRD, and GT in the control group (P < or =0.05); no differences were found for PD or KT (P > or =0.05). CONCLUSIONS: The coronally positioned flap associated with a subepithelial connective tissue graft or an acellular dermal matrix graft was effective in root coverage. However, the coronally positioned flap associated with a connective tissue graft provided a more favorable clinical outcome. More expanded studies are needed to confirm the present findings.

Modified coronally advanced flap associated with a subepithelial connective tissue graft for the treatment of adjacent multiple gingival recessions.

BACKGROUND: The clinical choice of the appropriate surgical technique aiming at root coverage relies, among other factors, on the number of adjacent gingival recessions. This study aimed to clinically evaluate the effectiveness and the predictability of root coverage at adjacent multiple gingival recessions using a modified coronally positioned flap associated with the subepithelial connective tissue graft. METHODS: Ten non-smoking, healthy subjects (five men and five women; mean age, 28.7 years) presenting 29 Class I or II adjacent multiple gingival recessions were enrolled. Each patient was treated using a modified coronally advanced flap associated with the subepithelial connective tissue graft. Probing depth (PD), clinical attachment level (CAL), recession depth (RD), and width of keratinized tissue (KT) were measured at baseline and 6 months later. The Student t test was used to compare treatment outcomes through time. RESULTS: The results revealed significant CAL gain (mean gain +/- SD, 1.97 +/- 0.94 mm; P <0.0001), RD decrease (2.03 +/- 0.78 mm; P <0.0001), and KT increase (1.31 +/- 1.23 mm, P <0.0001). The average root coverage was 96.7%, and complete root coverage was found at 93.1% of the defects. Nine of the 10 patients (90% of the patients) experienced complete root coverage. CONCLUSIONS: The modified coronally advanced flap associated with the subepithelial connective tissue graft was effective and predictable to produce root coverage at multiple adjacent gingival recessions associated with gain in the CAL and in the width of KT.