title: Coronally advanced flap alone or with connective tissue graft in the treatment of single gingival recession defects: a long-term randomized clinical trial.
abstract: BACKGROUND
  Numerous surgical approaches for the treatment of single gingival recession (GR) defects are documented in the literature. The aim of this 5-year, split mouth-design, randomized clinical trial was to evaluate the effectiveness of coronally advanced flap (CAF) alone versus CAF with connective tissue graft (CAF+CTG) in the treatment of single Miller Class I and II GR defects.
  
  
  METHODS
  Thirty-seven patients with 114 bilateral, single Miller Class I and II GR defects were treated with CAF on one side of the mouth and CAF+CTG on the other side. Clinical measurements (GR length [REC], keratinized tissue width [KT], complete root coverage [CRC], and percentage of root coverage [PRC]) were evaluated before surgery and after 6, 12, 24, and 60 months.
  
  
  RESULTS
  There was a significant reduction of REC and increase of KT after surgery in both groups. CAF+CTG showed significantly better results for all evaluated clinical parameters in all observed follow-up periods. Miller Class I defects showed better results in terms of REC, CRC, and PRC, whereas Miller Class II showed better results in KT, both in favor of CAF+CTG. Miller Class I defects showed better results than Miller Class II GR defects regardless of the surgical procedure used.
  
  
  CONCLUSIONS
  Both surgical procedures were effective in the treatment of single Miller Class I and II GR defects. The CAF+CTG procedure provided better long-term outcomes (60 months postoperatively) than CAF alone. Long-term stability of the gingival margin is less predictable for Miller Class II GR defects compared to those of Class I.
authors: Department of Oral Medicine and Periodontology, School of Dentistry, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
authors: Davor
authors: D
authors: Kuis
authors: Ivana
authors: I
authors: Sciran
authors: Vlatka
authors: V
authors: Lajnert
authors: Damir
authors: D
authors: Snjaric
authors: Jelena
authors: J
authors: Prpic
authors: Sonja
authors: S
authors: Pezelj-Ribaric
authors: Andrija
authors: A
authors: Bosnjak
mesh_terms: D000328:Adult; D003238:Connective Tissue / Q000637:transplantation; D003774:Dental Plaque Index; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology / Q000637:transplantation*; D005889:Gingival Recession / Q000145:classification / Q000601:surgery*; D006801:Humans; D007633:Keratins; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000145:classification; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification; D013524:Surgical Flaps / Q000601:surgery*; D019237:Tooth Cervix / Q000473:pathology; D014092:Tooth Root / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007633:Keratins