Coronally positioned flap for root coverage: poorer outcomes in smokers.
BACKGROUND
Gingival recession is significantly more common among smokers, while the relative outcome of various root coverage procedures in smokers, compared to non-smokers, is debatable. The objective of this study was to evaluate the influence of cigarette smoking on the outcome of coronally positioned flap (CPF) in the treatment of Miller Class I gingival recession defects.


METHODS
Ten current smokers (> or = 10 cigarettes daily for at least 5 years) and 10 non-smokers (never smokers), each with one 2- to 3-mm Miller Class I recession defect in an upper canine or bicuspid, were treated with CPF. At baseline and 6 months, clinical parameters, probing depth (PD), clinical attachment level (CAL), recession depth (RD), and apico-coronal width of keratinized tissue (KT) were determined.


RESULTS
Intragroup analysis showed that CPF was able to reduce RD and improve CAL in both groups (P <0.05). Intergroup analysis demonstrated that smokers presented greater residual RD at 6 months and lower percentage of root coverage (69.3% versus 91.3%; P <0.05). No smokers obtained complete root coverage compared to 50% of non-smokers (P <0.05).


CONCLUSIONS
Within the limits of the present study, it can be concluded that CPF provides benefits for both smokers and non-smokers in terms of root coverage of shallow Miller Class I recession defects. However, cigarette smoking negatively impacts the clinical outcomes, specifically residual recession, percent root coverage, and frequency of complete root coverage.
Silva
Cléverson Oliveira
CO
Department of Prosthodontics and Periodontics, School of Dentistry at Piracicaba, University of Campinas, São Paulo, Brazil. silvaco@fop.unicamp.br
Sallum
Antônio Wilson
AW
de Lima
Antônio Fernando Martorelli
AF
Tatakis
Dimitris N
DN
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology; D005889:Gingival Recession / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007633:Keratins; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000473:pathology / Q000601:surgery; D010514:Periodontal Pocket / Q000473:pathology / Q000601:surgery; D012907:Smoking / Q000009:adverse effects; D013524:Surgical Flaps / Q000145:classification* / Q000473:pathology; D019237:Tooth Cervix / Q000473:pathology; D014092:Tooth Root / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
D007633:Keratins