title: Surgical treatment of single gingival recessions: clinical guidelines.
abstract: OBJECTIVE
  The purpose of this clinical guidelines project was to determine the most appropriate surgical techniques, in terms of efficacy, complications, and patient opinions, for the treatment of buccal single gingival recessions without loss of interproximal soft and hard tissues.
  
  
  METHODS
  Literature searches were performed (electronically and manually) for entries up to 28 February, 2013 concerning the surgical approaches for the treatment of gingival recessions. Systematic reviews (SRs) of randomised controlled trials (RCTs) and individual RCTs that reported at least 6 months of follow-up of surgical treatment of single gingival recessions were included. The full texts of the selected SRs and RCTs were analysed using checklists for qualitative evaluation according to the Scottish Intercollegiate Guidelines Network (SIGN) method. The following variables were evaluated: Complete Root Coverage (CRC); Recession Reduction (RecRed); complications; functional and aesthetic satisfaction of the patients; and costs of therapies.
  
  
  RESULTS
  Out of 30 systematic reviews, 3 SRs and 16 out of 313 RCTs were judged to have a low risk for bias (SIGN code: 1+). At a short-term evaluation, the coronally advanced flap plus connective tissue graft method (CAF+CTG) resulted in the best treatment in terms of CRC and/or RecRed; in case of cervical abrasion and presence of root sensitivity CAF + CTG + Restoration caused less sensitivity than CAF+CTG. CAF produced less postoperative discomfort for patients. Limited information is available regarding postoperative dental hypersensitivity and aesthetic satisfaction of the patients.
  
  
  CONCLUSIONS
  In presence of aesthetic demands or tooth hypersensitivity, the best way to surgically treat single gingival recessions without loss of interproximal tissues is achieved using the CAF procedure associated with CTG. Considering postoperative discomfort, the CAF procedure is the less painful surgical approach, while the level of aesthetic satisfaction resulted higher after CAF either alone or with CTG. It is unclear how much tooth hypersensitivity is reduced by surgically covering buccal recessions. It is important to note that the present recommendations are based on short-term data (less than 1 year).
  
  
  BACKGROUND
  The guidelines project was made possible through self-financing by the authors.
authors.forename: Giovanpaolo
authors.initials: G
authors.lastname: Pini-Prato
authors.forename: Michele
authors.initials: M
authors.lastname: Nieri
authors.forename: Umberto
authors.initials: U
authors.lastname: Pagliaro
authors.forename: Teresa Schifter
authors.initials: TS
authors.lastname: Giorgi
authors.forename: Michele
authors.initials: M
authors.lastname: La Marca
authors.forename: Debora
authors.initials: D
authors.lastname: Franceschi
authors.forename: Jacopo
authors.initials: J
authors.lastname: Buti
authors.forename: Monica
authors.initials: M
authors.lastname: Giani
authors.forename: Julia Hanne
authors.initials: JH
authors.lastname: Weiss
authors.forename: Luigi
authors.initials: L
authors.lastname: Padeletti
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Cortellini
authors.forename: Leandro
authors.initials: L
authors.lastname: Chambrone
authors.forename: Luca
authors.initials: L
authors.lastname: Barzagli
authors.forename: Efisio
authors.initials: E
authors.lastname: Defraia
authors.forename: Roberto
authors.initials: R
authors.lastname: Rotundo
mesh_terms: D062088:Acellular Dermis; D057189:Checklist; D003094:Collagen / Q000627:therapeutic use; D003188:Composite Resins / Q000737:chemistry; D003746:Dental Enamel Proteins / Q000627:therapeutic use; D003764:Dental Materials / Q000737:chemistry; D003793:Dental Restoration, Permanent; D003807:Dentin Sensitivity / Q000601:surgery; D004955:Esthetics, Dental; D005881:Gingiva / Q000637:transplantation; D005889:Gingival Recession / Q000601:surgery*; D006406:Hematoma / Q000517:prevention & control; D006801:Humans; D008567:Membranes, Artificial; D010149:Postoperative Pain / Q000517:prevention & control; D017060:Patient Satisfaction; D010446:Peptide Fragments / Q000627:therapeutic use; D053657:Platelet-Rich Plasma / Q000502:physiology; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D012196:Review Literature as Topic; D017768:Skin, Artificial; D013524:Surgical Flaps / Q000601:surgery; D014092:Tooth Root / Q000601:surgery; D057085:Tooth Wear / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D003188:Composite Resins; D003746:Dental Enamel Proteins; D003764:Dental Materials; D008567:Membranes, Artificial; D010446:Peptide Fragments; C407062:cell-binding peptide P-15; C109069:enamel matrix proteins; D003094:Collagen