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Root coverage procedures for the treatment of localised recession-type defectsChambrone L, Sukekava F, Araújo MG, Pustiglioni FE, Chambrone LA, Lima LA
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SummaryRoot coverage procedures for the treatment of localised recession-type defectsGingival recession is a term that designates the oral exposure of the root surface due to a displacement of the gingival margin apical to the cemento-enamel junction and it is also regularly linked to the deterioration of dental aesthetics as well as buccal cervical dentine hypersensitivity. The results of this review have shown that the majority of periodontal plastic surgery (PPS) procedures led to statistical significant gains in gingival recession depth, clinical attachment level and in the width of keratinized tissue, 23/24 studies were however judged to be at high risk of bias. Also, we observed a great variability in the percentages of complete root coverage and mean coverage. Preferably, subepithelial connective tissue grafts, coronally advanced flaps alone or associated with other graft or biomaterial and guided tissue regeneration can be used as root coverage procedures for the treatment of recession-type defects. We recommend further research to adequately confirm and identify possible factors associated with the prognosis and indications of each PPS procedure.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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April 15. 2009 AbstractBackgroundGingival recession is defined as the oral exposure of the root surface due to a displacement of the gingival margin apical to the cemento-enamel junction and it is regularly linked to the deterioration of dental aesthetics. Successful treatment of recession-type defects is based on the use of predictable periodontal plastic surgery (PPS) procedures. ObjectivesTo evaluate the effectiveness of different root coverage procedures in the treatment of recession-type defects. Search strategyThe Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE were searched up to October 2008. The main international periodontal journals were handsearched. There were no restrictions with regard to publication status or language of publication. Selection criteriaOnly randomised controlled clinical trials (RCTs) of at least 6 months' duration evaluating recession areas (Miller's Class I or II > 3 mm) and that were treated by means of PPS procedures were included. Data collection and analysisScreening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted independently and in duplicate. Authors were contacted for any missing information. Results were expressed as random-effects models using mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confidence intervals. Main resultsTwenty-four RCTs provided data. Only one trial was considered to be at low risk of bias. The remaining trials were considered to be at high risk of bias. Authors' conclusionsSubepithelial connective tissue grafts, coronally advanced flap alone or associated with other biomaterial and guided tissue regeneration may be used as root coverage procedures for the treatment of localised recession-type defects. In cases where both root coverage and gain in the keratinized tissue are expected, the use of subepithelial connective tissue grafts seems to be more adequate. |