Root-coverage procedures for the treatment of localized recession-type defects: a Cochrane systematic review.
BACKGROUND
The purpose of this review is to evaluate the effectiveness of different root-coverage procedures in the treatment of recession-type defects.


METHODS
The Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE were searched for entries up to October 2008. There were no restrictions regarding publication status or the language of publication. Only clinical randomized controlled trials (RCTs) with a duration > or = 6 months that evaluated recession areas (Miller Class I or II > or = 3 mm) that were treated by means of periodontal plastic surgery procedures were included.


RESULTS
Twenty-four RCTs provided data. Only one trial was considered to be at low risk of bias. The remaining trials were considered to be at high risk of bias. The results indicated a significantly greater reduction in gingival recession and gain in keratinized tissue for subepithelial connective tissue grafts (SCTGs) compared to guided tissue regeneration (GTR) with bioabsorbable membranes (GTR bms). A significantly greater gain in keratinized tissue was found for enamel matrix protein compared to a coronally advanced flap (0.40 mm) and for SCTGs compared to GTR bms plus bone substitutes. Limited data exist on the changes of esthetic conditions as related to the opinions and preferences of patients for specific procedures.


CONCLUSIONS
SCTGs, coronally advanced flaps alone or associated with other biomaterial, and GTR may be used as root-coverage procedures for the treatment of localized recession-type defects. In cases where root coverage and gain in keratinized tissue are expected, the use of SCTGs seems to be more adequate.
Chambrone
Leandro
L
Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
Sukekava
Flávia
F
Araújo
Maurício G
MG
Pustiglioni
Francisco E
FE
Chambrone
Luiz Armando
LA
Lima
Luiz A
LA
D003094:Collagen; D003238:Connective Tissue / Q000637:transplantation; D003746:Dental Enamel Proteins / Q000627:therapeutic use; D005889:Gingival Recession / Q000188:drug therapy / Q000601:surgery*; D005893:Gingivoplasty / Q000379:methods; D016557:Guided Tissue Regeneration, Periodontal; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D013524:Surgical Flaps
C440568:Alloderm; D003746:Dental Enamel Proteins; C109069:enamel matrix proteins; D003094:Collagen