title: Coronally advanced flap + connective tissue graft techniques for the treatment of deep gingival recession in the lower incisors. A controlled randomized clinical trial.
abstract: OBJECTIVE
  The aim of this study was to compare the clinical and aesthetic outcomes of two different surgical approaches for the treatment of deep gingival recession affecting the mandibular incisors.
  
  
  METHODS
  Fifty patients with Miller class I and II gingival recessions (≥ 3 mm) in the lower incisors were enrolled. Twenty-five patients were randomly assigned to the control group and the other 25 patients to the test group. All defects were treated with the coronally advanced flap + connective tissue graft (CAF + CTG) and in the test group the labial submucosal tissue (LST) was removed. Post-operative morbidity was evaluated at 1 week. Clinical and aesthetic evaluations were made at 1 year.
  
  
  RESULTS
  Statistically greater recession reduction, probability of CRC (adjusted OR 7.94 95% CI = 1.88-33.50, p = 0.0024) and greater increase in GT were observed in the test group. Greater graft exposure and increase in KTH were demonstrated in the control group. Better aesthetics outcomes were observed in the test group. No statistically significant between groups differences were demonstrated in patient analgesic assumption and post-operative discomfort and bleeding.
  
  
  CONCLUSIONS
  LST removal during CAF + CTG surgery is indicated to provide better root coverage and aesthetic outcomes in the treatment of gingival recessions affecting the lower incisors.
authors.affiliation: Department of Biomedical and Neuromotor Sciences, Bologna University, Bologna, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Zucchelli
authors.forename: Matteo
authors.initials: M
authors.lastname: Marzadori
authors.forename: Ilham
authors.initials: I
authors.lastname: Mounssif
authors.forename: Claudio
authors.initials: C
authors.lastname: Mazzotti
authors.forename: Martina
authors.initials: M
authors.lastname: Stefanini
mesh_terms: D000539:Alveolar Process / Q000473:pathology; D003238:Connective Tissue / Q000637:transplantation; D003774:Dental Plaque Index; D004311:Double-Blind Method; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology / Q000637:transplantation*; D005889:Gingival Recession / Q000145:classification / Q000601:surgery*; D006801:Humans; D007180:Incisor / Q000473:pathology / Q000601:surgery; D007633:Keratins; D008297:Male; D008334:Mandible; D010149:Postoperative Pain / Q000145:classification; D017060:Patient Satisfaction; D017622:Periodontal Attachment Loss / Q000145:classification; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification; D010865:Pilot Projects; D019106:Postoperative Hemorrhage / Q000145:classification; D013524:Surgical Flaps / Q000601:surgery*; D014092:Tooth Root / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D007633:Keratins
keywords: aesthetics; coronally advanced flap + connective tissue graft; lower incisors; multiple gingival recession; root coverage; surgery