Factors affecting the outcomes of coronally advanced flap root coverage procedure.
BACKGROUND
The coronally advanced flap (CAF) has been used to treat gingival recession. However, the final outcomes (percentage of root coverage) vary from case to case. Hence, the purpose of this study was to analyze the factors that may affect the results of CAF root coverage procedures.


METHODS
Twenty-three systemically healthy patients (mean age, 43.8 +/- 11.9 years) each with one Miller's Class I buccal recession defect were included. Baseline clinical parameters included recession depth (RD), recession width (RW), gingival thickness (GT), width of keratinized tissue (WKT), clinical attachment level (CAL), probing depth (PD), plaque index (PI), and gingival index (GI). CAF root coverage procedures were performed to correct the recession defects. Patients were followed at 2, 4, 12, and 24 weeks post-surgery, at which time wound healing index (WHI) and other measurements were recorded.


RESULTS
The mean baseline RD was 2.9 +/- 0.4 mm; RW, 3.4 +/- 0.6 mm; WKT, 2.7 +/- 1.3 mm; and GT, 1.1 +/- 0.3 mm. At mid-buccal, the mean CAL was 4.5 +/- 0.8 mm. Six months after surgery, the average RC was 82.3% +/- 24.7%; RD, 0.5 +/- 0.7 mm; RW, 0.4 +/- 0.9 mm; WKT, 3.2 +/- 0.9 mm; and GT, 1.5 +/- 0.5 mm. At mid-buccal, the mean CAL was 1.8 +/- 1.1 mm. From baseline to the 6-month follow-up, the changes of RC, RD, RW, WKT, GT, and CAL showed statistical significance (P < 0.05). Fourteen patients achieved 100% RC. The mean RC in partial coverage cases was 54.8% +/- 16.8%. Analysis revealed that an initial GT thicker than 1.2 +/- 0.3 mm was associated with complete root coverage at the 6-month follow-up (P < 0.05).


CONCLUSIONS
CAF is a predictable procedure to treat Miller's Class I mucogingival defects. Initial GT was the most significant factor associated with complete root coverage.
Huang
Lien-Hui
LH
Department of Periodontics, Prevention, and Geriatrics, University of Michigan School of Dentistry, Anne Arbor, MI 48109, USA.
Neiva
Rodrigo E F
RE
Wang
Hom-Lay
HL
D000328:Adult; D003774:Dental Plaque Index; D005260:Female; D005881:Gingiva / Q000033:anatomy & histology; D005889:Gingival Recession / Q000473:pathology / Q000601:surgery*; D005893:Gingivoplasty / Q000379:methods*; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010512:Periodontal Index; D012044:Regression Analysis; D018709:Statistics, Nonparametric; D013524:Surgical Flaps