Modified coronally advanced flap associated with a subepithelial connective tissue graft for the treatment of adjacent multiple gingival recessions.
BACKGROUND
The clinical choice of the appropriate surgical technique aiming at root coverage relies, among other factors, on the number of adjacent gingival recessions. This study aimed to clinically evaluate the effectiveness and the predictability of root coverage at adjacent multiple gingival recessions using a modified coronally positioned flap associated with the subepithelial connective tissue graft.


METHODS
Ten non-smoking, healthy subjects (five men and five women; mean age, 28.7 years) presenting 29 Class I or II adjacent multiple gingival recessions were enrolled. Each patient was treated using a modified coronally advanced flap associated with the subepithelial connective tissue graft. Probing depth (PD), clinical attachment level (CAL), recession depth (RD), and width of keratinized tissue (KT) were measured at baseline and 6 months later. The Student t test was used to compare treatment outcomes through time.


RESULTS
The results revealed significant CAL gain (mean gain +/- SD, 1.97 +/- 0.94 mm; P <0.0001), RD decrease (2.03 +/- 0.78 mm; P <0.0001), and KT increase (1.31 +/- 1.23 mm, P <0.0001). The average root coverage was 96.7%, and complete root coverage was found at 93.1% of the defects. Nine of the 10 patients (90% of the patients) experienced complete root coverage.


CONCLUSIONS
The modified coronally advanced flap associated with the subepithelial connective tissue graft was effective and predictable to produce root coverage at multiple adjacent gingival recessions associated with gain in the CAL and in the width of KT.
Carvalho
Paulo F M
PF
Department of Periodontics, São Leopoldo Mandic Dental Research Institute, Campinas, São Paulo (SP), Brazil.
da Silva
Robert C
RC
Cury
Patrícia R
PR
Joly
Julio C
JC
D000328:Adult; D003238:Connective Tissue / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000637:transplantation*; D005889:Gingival Recession / Q000601:surgery*; D005893:Gingivoplasty / Q000379:methods*; D006801:Humans; D008297:Male; D013524:Surgical Flaps; D016896:Treatment Outcome