Francesco Cairo1, Pierpaolo Cortellini2, Andrea Pilloni3, Michele Nieri4, Sandro Cincinelli4, Franco Amunni5, Gabriella Pagavino6, Maurizio S Tonetti7. 1. Section of Periodontology, Department of Surgery and Translational Medicine, A.O.U. Careggi, University of Florence, Florence, Italy. cairofrancesco@virgilio.it. 2. Accademia Toscana di Ricerca Odontostomatologia (ATRO), Florence, Italy. 3. Section of Periodontology, University "La Sapienza" of Rome, Rome, Italy. 4. Section of Periodontology, Department of Surgery and Translational Medicine, A.O.U. Careggi, University of Florence, Florence, Italy. 5. Unit of Special Care Dentistry, A.O.U. Careggi, University of Florence, Florence, Italy. 6. Section of Endodontics, Department of Surgery and Translational Medicine, A.O.U. Careggi, University of Florence, Florence, Italy. 7. European Research Group on Periodontology (ERGOPERIO), Berne, Switzerland.
Abstract
BACKGROUND: The aim of this study was to assess the clinical efficacy of coronally advanced flap (CAF) with or without connective tissue graft (CTG) for the treatment of multiple adjacent gingival recessions in the upper arch. MATERIAL AND METHODS:Thirty-two patients with a total of 74 gingival recessions were randomly allocated to the two groups. Outcome measures, collected by a blind examiner, included complete root coverage (CRC), recession reduction (RecRed), keratinized tissue (KT) gain, increase in gingival thickness (GT), patient satisfaction and root coverage esthetic score (RES). RESULTS: An interaction between treatment and baseline GT was detected. At 1 year, CAF + CTG resulted in better outcomes in terms of CRC (p = 0.0016) and RecRed (p < 0.0001) than CAF alone at sites with thin gingiva (thickness ≤ 0.8 mm). No difference was found between CAF alone and CAF + CTG at sites with thick gingiva (>0.8 mm). CAF resulted in higher aesthetic scores (RES) than CAF + CTG at sites with thick gingiva. CAF + CTG was associated with greater KT gain (p < 0.0001) and greater post-operative morbidity (p < 0.0001). CONCLUSION: Connective tissue graft under CAF results in increased probability of CRC only at sites with thin baseline gingiva. CAF alone is associated with similar clinical outcomes and better aesthetics at sites with thick baseline gingiva.
RCT Entities:
BACKGROUND: The aim of this study was to assess the clinical efficacy of coronally advanced flap (CAF) with or without connective tissue graft (CTG) for the treatment of multiple adjacent gingival recessions in the upper arch. MATERIAL AND METHODS: Thirty-two patients with a total of 74 gingival recessions were randomly allocated to the two groups. Outcome measures, collected by a blind examiner, included complete root coverage (CRC), recession reduction (RecRed), keratinized tissue (KT) gain, increase in gingival thickness (GT), patient satisfaction and root coverage esthetic score (RES). RESULTS: An interaction between treatment and baseline GT was detected. At 1 year, CAF + CTG resulted in better outcomes in terms of CRC (p = 0.0016) and RecRed (p < 0.0001) than CAF alone at sites with thin gingiva (thickness ≤ 0.8 mm). No difference was found between CAF alone and CAF + CTG at sites with thick gingiva (>0.8 mm). CAF resulted in higher aesthetic scores (RES) than CAF + CTG at sites with thick gingiva. CAF + CTG was associated with greater KT gain (p < 0.0001) and greater post-operative morbidity (p < 0.0001). CONCLUSION: Connective tissue graft under CAF results in increased probability of CRC only at sites with thin baseline gingiva. CAF alone is associated with similar clinical outcomes and better aesthetics at sites with thick baseline gingiva.
Authors: Y Shirakata; T Nakamura; Y Shinohara; K Nakamura-Hasegawa; C Hashiguchi; N Takeuchi; T Imafuji; A Sculean; K Noguchi Journal: Clin Oral Investig Date: 2018-12-01 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