Coronally advanced flap achieved higher esthetic outcomes without a connective tissue graft for the treatment of single
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ORIGINAL ARTICLE
Coronally advanced flap achieved higher esthetic outcomes without a connective tissue graft for the treatment of single gingival recessions: a 4-year randomized clinical trial Stephany Gil 1 & Manuel de la Rosa 2 & Evelyn Mancini 3 & Antonio Dias 1 & Shayan Barootchi 4 & Lorenzo Tavelli 4 Gerardo Mendoza-azpur 1
&
Received: 22 July 2020 / Accepted: 14 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives Limited long-term data are available when comparing the esthetic outcomes of coronally advanced flap (CAF) with or without a connective tissue graft (CTG). The aim of this study was to compare the 4-year esthetic outcomes of CAF vs CAF + CTG for the treatment of isolated maxillary gingival recessions. Material and methods Forty-eight patients were randomly assigned for treatment either with CAF (control; N = 24) or to CAF + CTG (test group; N = 24). Patients were followed after the surgery until the final evaluation. A professional esthetic evaluation was performed using the Root coverage Esthetic Score (RES). Recession reduction, mean root coverage, and complete root coverage were also evaluated. Results Forty-two patients completed the study at the 4-year recall. A significant recession reduction was evident at 4 years, without significant intergroup differences. The CAF group showed a statistically significant higher final RES compared with the CAF + CTG group (9.14 ± 1.08 vs 7.25 ± 1.29, respectively, p < 0.001). Regarding the individual components of RES, gingival margin and marginal tissue contour were significantly higher in the CAF group compared with that in the CAF + CTG group. Conclusions CAF presented with a significantly higher overall esthetic score than CAF + CTG, and in the individual RES components of marginal tissue contour and gingival margin after 4 years. Clinical relevance CAF without the addition of CTG provided higher esthetic outcomes for the treatment of isolated gingival recessions. Keywords Gingival recession . Esthetics . Connective tissue graft . Surgical flaps . Tooth root
Introduction Gingival recession (GR) is defined as the apical shift of the gingival margin with respect to the cemento-enamel junction (CEJ) with the concomitant exposure of a * Gerardo Mendoza-azpur [email protected] 1
Department of Periodontology, School of Dentistry, Universidad Científica del Sur, Calle Cantuarias 398, Miraflores, 15074 Lima, Peru
2
Department of Periodontics, AME University Monterrey, Monterrey, Mexico
3
Private Practice, Rosario, Argentina
4
Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
portion of the root surface to the oral environment [1]. GR represents a common clinical finding [2, 3], with a prevalence that according to Rios et al. can be up to 99.7% [4]. The high prevalence of these mucogingival defects can be attributed to a large variety of predisposing and precipitating factors, including traumatic toothbrushing, periodontal disease, tooth malp
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