Francesco Cairo1, Umberto Pagliaro2, Jacopo Buti3, Michela Baccini4,5, Filippo Graziani6, Paolo Tonelli7, Gabriella Pagavino8, Maurizio S Tonetti9. 1. Section of Periodontology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. cairofrancesco@virgilio.it. 2. Private Practice, Florence, Italy. 3. School of Dentistry, University of Manchester, Manchester, UK. 4. Department of Statistics, Informatics and Applications "G. Parenti", University of Florence, Florence, Italy. 5. Biostatistics Unit, ISPO Cancer Prevention and Research Institute, Florence, Italy. 6. Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy. 7. Section of Oral Surgery, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. 8. Section of Endodontics, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy. 9. European Research Group on Periodontology (ERGOPERIO), Berne, Switzerland.
Abstract
BACKGROUND: The aim of this study was to perform a systematic review (SR) of randomized controlled trials (RCTs) to explore if periodontal plastic surgery procedures for the treatment of single and multiple gingival recessions (Rec) may improve aesthetics at patient and professional levels. MATERIAL AND METHODS: In order to combine evidence from direct and indirect comparisons by different trials a Bayesian network meta-analysis (BNM) was planned. A literature search on PubMed, Cochrane libraries, EMBASE, and hand-searched journals until January 2016 was conducted to identify RCTs presenting aesthetic outcomes after root coverage using standardized evaluations at patient and professional level. RESULTS: A total of 16 RCTs were selected in the SR; three RTCs presenting professional aesthetic evaluation with Root coverage Aesthetic Score (RES) and three showing final self-perception using the Visual Analogue Scale (VAS Est) could be included in a BNM model. Coronally Advanced Flap plus Connective Tissue Graft (CAF + CTG) and CAF + Acellular Dermal Matrix (ADM) and Autologous Fibroblasts (AF) were associated with the best RES outcomes (best probability = 24% and 64%, respectively), while CAF + CTG and CAF + CTG + Enamel matrix Derivatives (EMD) obtained highest values of VAS Est score (best probability = 44% and 26%, respectively). CONCLUSIONS: Periodontal Plastic Surgery (PPS) techniques applying grafts underneath CAF with or without the adding of EMD are associated with improved aesthetics assessed by final patient perception and RES as professional evaluation system.
BACKGROUND: The aim of this study was to perform a systematic review (SR) of randomized controlled trials (RCTs) to explore if periodontal plastic surgery procedures for the treatment of single and multiple gingival recessions (Rec) may improve aesthetics at patient and professional levels. MATERIAL AND METHODS: In order to combine evidence from direct and indirect comparisons by different trials a Bayesian network meta-analysis (BNM) was planned. A literature search on PubMed, Cochrane libraries, EMBASE, and hand-searched journals until January 2016 was conducted to identify RCTs presenting aesthetic outcomes after root coverage using standardized evaluations at patient and professional level. RESULTS: A total of 16 RCTs were selected in the SR; three RTCs presenting professional aesthetic evaluation with Root coverage Aesthetic Score (RES) and three showing final self-perception using the Visual Analogue Scale (VAS Est) could be included in a BNM model. Coronally Advanced Flap plus Connective Tissue Graft (CAF + CTG) and CAF + Acellular Dermal Matrix (ADM) and Autologous Fibroblasts (AF) were associated with the best RES outcomes (best probability = 24% and 64%, respectively), while CAF + CTG and CAF + CTG + Enamel matrix Derivatives (EMD) obtained highest values of VAS Est score (best probability = 44% and 26%, respectively). CONCLUSIONS: Periodontal Plastic Surgery (PPS) techniques applying grafts underneath CAF with or without the adding of EMD are associated with improved aesthetics assessed by final patient perception and RES as professional evaluation system.
Authors: Bukkapatnam Venkata Subbareddy; Penmetsa S Gautami; C D Dwarakanath; Panda Kausalya Devi; Parimisetti Bhavana; K Radharani Journal: Contemp Clin Dent Date: 2020-11-26
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