OBJECTIVE: To systematically review the efficacy of periodontal plastic procedures (PPP) in the treatment of multiple gingival recessions (MGR). METHODS: Randomized clinical trials (RCT) on MGR treatment with at least 6 months duration were identified through electronic databases and hand-searched journals. Primary outcomes were complete root coverage (CRC) and percentage of root coverage (PRC). Weighted means and forest plots were calculated for all PPP. Subgroup analysis was performed according to the type of flap. A Bayesian network meta-analysis (NM) on secondary outcomes was also performed. RESULTS: Nine trials including 208 subjects and 858 recessions were identified. CRC after PPP was 24-89%. Mean weighted PRC was 86.27% (95% CI 80.71-91.83; p < 0.01). Heterogeneity of the literature prevented inter-techniques comparison. Coronally advanced flap (CAF) shows the higher variability in terms of CRC. Modified CAF and tunnel approaches show higher level of CRC. The NM suggests that CAF plus graft showed the higher probability of being the best treatment. CONCLUSIONS: Limited evidence is available for MGR coverage. PPP are associated with high level of efficacy, in terms of PRC, and high variability of CRC. Indirect evidence indicates that CAF may benefit from newer variations of the technique and by the additional use of grafting.
OBJECTIVE: To systematically review the efficacy of periodontal plastic procedures (PPP) in the treatment of multiple gingival recessions (MGR). METHODS: Randomized clinical trials (RCT) on MGR treatment with at least 6 months duration were identified through electronic databases and hand-searched journals. Primary outcomes were complete root coverage (CRC) and percentage of root coverage (PRC). Weighted means and forest plots were calculated for all PPP. Subgroup analysis was performed according to the type of flap. A Bayesian network meta-analysis (NM) on secondary outcomes was also performed. RESULTS: Nine trials including 208 subjects and 858 recessions were identified. CRC after PPP was 24-89%. Mean weighted PRC was 86.27% (95% CI 80.71-91.83; p < 0.01). Heterogeneity of the literature prevented inter-techniques comparison. Coronally advanced flap (CAF) shows the higher variability in terms of CRC. Modified CAF and tunnel approaches show higher level of CRC. The NM suggests that CAF plus graft showed the higher probability of being the best treatment. CONCLUSIONS: Limited evidence is available for MGR coverage. PPP are associated with high level of efficacy, in terms of PRC, and high variability of CRC. Indirect evidence indicates that CAF may benefit from newer variations of the technique and by the additional use of grafting.
Authors: Adrian Kasaj; Liran Levin; Stefan-Ioan Stratul; Hermann Götz; Markus Schlee; Constantin B Rütters; Moritz A Konerding; Maximilian Ackermann; Brita Willershausen; Andreas M Pabst Journal: Clin Oral Investig Date: 2015-10-05 Impact factor: 3.573
Authors: Alexandra Stähli; Jean-Claude Imber; Elena Raptis; Giovanni E Salvi; Sigrun Eick; Anton Sculean Journal: Clin Oral Investig Date: 2019-07-09 Impact factor: 3.573
Authors: Maurizio S Tonetti; Pierpaolo Cortellini; Gaia Pellegrini; Michele Nieri; Daniele Bonaccini; Mario Allegri; Philippe Bouchard; Francesco Cairo; Gianpaolo Conforti; Ioannis Fourmousis; Filippo Graziani; Adrian Guerrero; Jan Halben; Jacques Malet; Giulio Rasperini; Heinz Topoll; Hannes Wachtel; Beat Wallkamm; Ion Zabalegui; Otto Zuhr Journal: J Clin Periodontol Date: 2017-11-21 Impact factor: 8.728
Authors: Ramón Gómez-Meda; Carlos Torres-Sanchez; Santiago Mareque-Bueno; Juan Zufía-González; Daniel Torres-Lagares; José-Luis Gutierrez-Pérez Journal: J Clin Exp Dent Date: 2018-05-01
Authors: Marcelle M Nascimento; Deborah A Dilbone; Patricia Nr Pereira; Wagner R Duarte; Saulo Geraldeli; Alex J Delgado Journal: Clin Cosmet Investig Dent Date: 2016-05-03
Authors: Chiara Giacomelli; Letizia Natali; Marco Nisi; Marinella De Leo; Simona Daniele; Barbara Costa; Filippo Graziani; Mario Gabriele; Alessandra Braca; M Letizia Trincavelli; Claudia Martini Journal: Stem Cell Res Ther Date: 2018-05-11 Impact factor: 6.832