title: Prevention of gingival recession following flap debridement surgery by subepithelial connective tissue graft: consecutive case series.
abstract: BACKGROUND
  Surgical debridement with flap repositioning may result in significant gingival recession. This manuscript reports on a series of cases that were treated for deep periodontal pockets by flap debridement surgery combined with subepitheial connective tissue graft for the prevention of postoperative recession.
  
  
  METHODS
  Fourteen patients (27 teeth) with deep periodontal pockets and bone loss in the mandibular central incisors area underwent flap debridement combined with subepithelial connective tissue graft. Probing depth, recession depth, and clinical attachment levels were recorded prior to surgery, 6 months post-surgery, and again 19 to 58 months post-surgery.
  
  
  RESULTS
  Mean probing depth at baseline was 6.20 mm, while 6 months post-surgery it was 1.97 mm (P < 0.0001), and 19 to 58 months after surgery it was 1.32 mm. Clinical attachment level measurements followed the same pattern (baseline 9.37 mm, 6 months 3.29 mm, final examination 2.00 mm). While the mean recession depth at baseline was 3.17 mm, 6 months post-surgery it was reduced to 1.30 mm (P < 0.0001). Additional reduction in recession depth was recorded over time.
  
  
  CONCLUSIONS
  Within the limitations of a single group study, the results suggest that flap debridement combined with subepithelial connective tissue graft, followed by maintenance therapy, is an effective procedure for maintaining long-term periodontal health and for prevention of postoperative gingival recession in the mandibular anterior dentition.
authors.affiliation: Department of Periodontology, Faculty of Dental Medicine, Hadassah and Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Ariel
authors.initials: A
authors.lastname: Hirsch
authors.forename: Laurentiu
authors.initials: L
authors.lastname: Brayer
authors.forename: Lior
authors.initials: L
authors.lastname: Shapira
authors.forename: Moshe
authors.initials: M
authors.lastname: Goldstein
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000601:surgery; D003238:Connective Tissue / Q000637:transplantation; D003646:Debridement; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000637:transplantation*; D005889:Gingival Recession / Q000517:prevention & control*; D006801:Humans; D007180:Incisor / Q000473:pathology; D008297:Male; D008336:Mandibular Diseases / Q000601:surgery; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D013524:Surgical Flaps