Single-stage advanced versus rotated flaps in the treatment of gingival recessions: A 5-year longitudinal randomized clinical trial.

BACKGROUND: The objective of the present study was to compare the efficacy of single-stage laterally positioned flap (LPF) and coronally advanced flap (CAF) techniques in the treatment of localized maxillary gingival recession (GR) defects, 1 and 5 years after surgical procedures. METHODS: Thirty-six patients with Miller Class I GR defects were randomly assigned to be treated by either CAF (n = 18) or LPF (n = 18). Recession height (RECH), width of keratinized tissue (WKT), probing depth (PD), vertical clinical attachment level (VAL), visual plaque score (VPS), and bleeding on probing (BOP) were assessed and compared. Clinical recordings were performed at baseline, 1 and 5 years later. The differences between initial clinical recordings and after 1 and 5 years were subjected to statistical analysis. RESULTS: Both flap designs effectively improved RECH and VAL on GR defects. The LPF resulted in significantly more gains in KTW and root coverage (RC) after 5 years. CONCLUSION: LPF and CAF procedures may be used for the treatment of GR, however, LPF results in greater longitudinal stability of RC and increased WKT in the treated areas.

Clinical evaluation of single-stage advanced versus rotated flaps in the treatment of gingival recessions.

BACKGROUND: Several procedures have been reported for the surgical correction of gingival recession (GR), including the laterally positioned flap (LPF) and the coronally advanced flap (CAF), performed as single- or two-stage procedures without or with, respectively, the preceding placement and healing of a free gingival graft. The objective of the present report was to compare the efficacy of single-stage LPF and CAF techniques in the treatment of localized maxillary GR defects. METHODS: Thirty-six patients, 10 men and 26 women, with average age of 34 + or - 9 years with Miller Class I GR defects were randomly assigned to be treated by either a CAF (n = 18) or LPF (n = 18). Clinical parameters, including recession height, the width of keratinized tissue (WKT), probing depth, and vertical clinical attachment level were assessed at the mid-buccal site. Visual plaque score and bleeding on probing were also assessed dichotomously. Clinical recordings were performed at baseline and 6 months later. Intermeasurements differences were analyzed with a chi-square or a Wilcoxon test, with significance set at alpha<0.05. RESULTS: Both flap designs were effective in treating recession defects resulting in similar improvements for percentage of root coverage, frequency of complete root coverage, and gain in clinical attachment level. The LPF resulted in significantly more gains in WKT than the CAF. CONCLUSION: The results obtained by CAF in the treatment of Miller Class I maxillary GR are clinically similar to the LPF albeit with more limited gains in WKT.