Obtaining predictable root coverage has been a goal of periodontal therapy for sometime. The purpose of this study is to present a technique for obtaining root coverage. This study reports the results of 20 patients (30 defects) treated with a connective tissue and partial thickness double pedicle graft. Root coverage of 100% was obtained in 24 of 30 defects, or 80% of the time. In all the treated defects the root coverage obtained was to within 0.5 mm of the cemento-enamel junction. The mean percent root coverage was 97.4%. The mean amount of exposed root surface initially was 3.6 mm. At the final postoperative appointment the mean exposed root surface was 0.1 mm. This change represents a net root coverage of 3.5 mm or 97.2%. The number of sites with bleeding on probing and plaque present decreased. The esthetics, both color match and tissue contours, were acceptable to all the patients in all cases. With this technique root coverage can be accomplished in a predictable manner.

The mean results with the subepithelial graft held up with time better than the mean results with an acellular dermal matrix. However, the results were not universal. In 32.0% of the cases treated with an acellular dermal matrix, the results improved or remained stable with time.

Obtaining predictable root coverage has been a goal of periodontal therapy for some time. The connective tissue with partial thickness double pedicle graft has been shown to produce predictable esthetic root coverage. The purpose of this study was to examine the results of the surgical technique on 100 consecutively treated defects. The procedure produced a mean root coverage of 97.7%. Root coverage of 100% was obtained 89% of the time. With this technique, esthetic root coverage can be accomplished in a predictable manner. Additionally, it was the intent of this study to examine whether or not certain factors could be associated with root coverage results. Factors that could be associated with root coverage success or lack of success included: size of the pedicle, previous free gingival graft, and plaque control during the postoperative period. Factors that did not appear to be related to root coverage included: history of smoking (heavy or light), defect width, defect depth, history of snuff use, history of orthodontics, tooth type treated, number of defects treated, age, preoperative bleeding on probing, preoperative plaque present, esthetic concerns of the patient, and surgical experience of the operator. Additionally, attached gingiva levels were not a factor if the areas had not been treated with a free gingival graft.

Obtaining predictable root coverage has become an important part of periodontal therapy. The purpose of this study was to compare two techniques of obtaining root coverage. The two techniques were the connective tissue with partial-thickness double pedicle graft and guided tissue regeneration with a bioabsorbable polylactic acid softened with citric acid ester membrane. The connective tissue with partial-thickness double pedicle graft had a mean root coverage of 97.1%, and the guided tissue regeneration procedure produced a mean root coverage of 75.1%. This difference was not statistically significant. Additionally, it was the goal of this study to determine if the thickness of the tissue near the defect was a factor in root coverage. Thickness of the tissue was not a factor with the connective tissue with partial-thickness double pedicle graft. The thin areas had a mean root coverage of 100%, while the others had a mean root coverage of 95.9%. This difference was not statistically significant; however, the thickness of the tissue was a factor in root coverage success in the guided tissue regeneration procedure. The thin areas treated with guided tissue regeneration had a mean root coverage of 26.7%, while the others had a mean root coverage of 95.9%. This difference was statistically significant. The results of this study demonstrate that root coverage is possible with both procedures. However, when the tissue in the area of the defect is relatively thin, the connective tissue with partial-thickness double pedicle graft will produce greater root coverage. When treating defects with tissue that is not thin, similar amounts of root coverage can be obtained with both procedures.

Root coverage can be achieved by many techniques. In this case report a patient was treated with a connective tissue with partial thickness double pedicle graft, which resulted in complete root coverage. However, 6 days postsurgery the patient developed a bleeding problem from the palatal donor area. For this reason, a unique approach was used to treat the next area needing root coverage. The procedure combined an acellular dermal matrix and a coronally positioned pedicle. The procedure was used to treat 3 defects. Complete root coverage was obtained on 2 of the 3 defects. The third was covered to within 1 mm of the cemento-enamel junction (CEJ). Histology showed similar results with a connective tissue graft and an acellular dermal matrix. Verhoeff's staining demonstrated that the acellular dermal matrix was incorporated into the gingival tissue. This case report demonstrated that acceptable results can be obtained with the connective tissue with partial thickness double pedicle graft and the acellular dermal matrix combined with a coronally positioned pedicle, both clinically and histologically.