Semilunar coronally positioned flap or subepithelial connective tissue graft for the treatment of gingival recession: a 30-month follow-up study.
BACKGROUND
The objective of this prospective, controlled clinical trial was to evaluate the long-term outcomes of subepithelial connective tissue graft (SCTG) or semilunar coronally positioned flap (SCPF) for the treatment of Miller Class I gingival recession defects.


METHODS
Seventeen patients with bilateral Miller Class I gingival recessions (< or =4.0 mm) in maxillary canines or premolars were selected. The recessions were randomly assigned to receive SCPF or SCTG. Recession height (RH), recession width (RW), width of keratinized tissue (WKT), thickness of keratinized tissue (TKT), probing depth (PD), and clinical attachment level (CAL) were measured at baseline and at 6 and 30 months post-surgery. Patient satisfaction with esthetics and root sensitivity was also evaluated.


RESULTS
The root-coverage outcomes obtained at 6 months were maintained throughout the study. At the 30-month examination, the average percentage of root coverage was 89.25% for SCPF and 96.83% for SCTG (P >0.05); complete root coverage was observed in 58.82% and 88.24% of patients, respectively. SCTG maintained a statistically significant increase in TKT (P <0.05) at 30 months. At this time, there were no significant differences between the two groups with regard to RH, RW, WKT, PD, and CAL. The evaluation of the esthetic outcome by the patient showed a preference for the SCTG treatment. Furthermore, in this group, no patient complained of residual or additional root hypersensitivity. In the SCPF group, three patients had this complaint at 30 months.


CONCLUSIONS
SCPF and SCTG can be successfully used to treat Class I gingival recession, presenting outcomes with long-term stability. However, patient-oriented outcomes, such as esthetics and root sensitivity, favor SCTG therapy.
Bittencourt
Sandro
S
Department of Prosthodontics and Periodontics, Division of Periodontics, School of Dentistry at Piracicaba, University of Campinas, Piracicaba, SP, Brazil.
Ribeiro
Erica Del Peloso
Edel P
Sallum
Enilson A
EA
Sallum
Antônio W
AW
Nociti
Francisco H
FH
Casati
Márcio Zaffalon
MZ
D000328:Adult; D003238:Connective Tissue / Q000637:transplantation; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000601:surgery*; D005889:Gingival Recession / Q000145:classification / Q000601:surgery*; D005893:Gingivoplasty / Q000379:methods*; D006801:Humans; D008297:Male; D008437:Maxilla; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation; D010159:Palate; D017060:Patient Satisfaction; D011446:Prospective Studies; D016037:Single-Blind Method; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult