title: Does placement of a connective tissue graft improve the outcomes of coronally advanced flap for coverage of single gingival recessions in upper anterior teeth? A multi-centre, randomized, double-blind, clinical trial.
abstract: OBJECTIVE
  This parallel-group, multi-centre, double-blind, randomized-controlled clinical trial was undertaken to compare the clinical outcomes and patient morbidity of coronally advanced flap (CAF) alone or in combination with a connective tissue graft (CAF+CTG) in single Miller Class I and II gingival recessions.
  
  
  METHODS
  Three centres enrolled 85 patients with one recession each. Surgery was performed elevating a pedicle flap; 42 sites randomly received a graft under the flap. Measurements were taken by blind and calibrated examiners. Outcome measures included recession reduction, complete root coverage (CRC), intra-operative and post-operative morbidity, dentine sensitivity, and side effects.
  
  
  RESULTS
  No differences were noted in the intra-operative and post-operative patient-related variables between the two groups. Surgical time was significantly shorter in the CAF group. Recession reduction was not statistically different between the two groups, even though a model showed a tendency towards improved outcomes in sites treated with CAF+CTG (adjusted difference 0.33 mm, 95% CI=-0.06 to 0.72, p=0.1002). Significantly greater probability of CRC was observed after CAF+CTG (adjusted OR=5.09, 95% CI=1.69-17.57, p=0.0033). Dentine hypersensitivity improved in both the groups.
  
  
  CONCLUSIONS
  Both treatments were effective in providing a significant reduction of the baseline recession and dentine hypersensitivity, with only limited intra-operative and post-operative morbidity and side effects. Adjunctive application of a CTG under a CAF increased the probability of achieving CRC in maxillary Miller Class I and II defects.
authors.affiliation: Accademia Toscana di Ricerca Odontostomatologia (ATRO), Florence, Italy. studiocortellini@cortellini.191.it
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Cortellini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Tonetti
authors.forename: Carlo
authors.initials: C
authors.lastname: Baldi
authors.forename: Luca
authors.initials: L
authors.lastname: Francetti
authors.forename: Giulio
authors.initials: G
authors.lastname: Rasperini
authors.forename: Roberto
authors.initials: R
authors.lastname: Rotundo
authors.forename: Michele
authors.initials: M
authors.lastname: Nieri
authors.forename: Debora
authors.initials: D
authors.lastname: Franceschi
authors.forename: Antonella
authors.initials: A
authors.lastname: Labriola
authors.forename: Giovanpaolo Pini
authors.initials: GP
authors.lastname: Prato
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D003238:Connective Tissue / Q000637:transplantation*; D003481:Cuspid; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005889:Gingival Recession / Q000145:classification / Q000601:surgery*; D005893:Gingivoplasty / Q000379:methods*; D006801:Humans; D007180:Incisor; D008437:Maxilla; D008875:Middle Aged; D013524:Surgical Flaps; D019228:Tooth Crown; D014092:Tooth Root; D016896:Treatment Outcome