Efficacy of modified coronally advanced flap in the treatment of multiple adjacent gingival recessions: a systematic review and meta-analysis

Bhatia, Anu; Yadav, Vikender Singh; Tewari, Nitesh; Kumar, Ashish; Sharma, Rajinder Kumar

doi:10.1080/00016357.2021.1908594

Cited by 5 publications

(4 citation statements)

References 47 publications

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“…The beneficial effect of applying a graft to treat GR is undeniable, however the question about the use of polymeric tissue substitutes in conjunction with either technique has yet to be answered. Bhatia et al, in a recent meta-analysis [ 56 ], showed that combining a CAF with a connective tissue graft or a PolS (collagen matrix) had a significantly higher probability of complete root coverage than a CAF alone. These results were supported by the findings of other authors [ 47 , 57 ].…”

Section: Discussionmentioning

confidence: 99%

Treating Gingival Recessions Using Coronally Advanced Flap or Tunnel Techniques with Autografts or Polymeric Substitutes: A Systematic Review and Meta-Analysis

et al. 2022

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Gingival recessions are a prevalent oral mucosa alteration. To solve this pathology, palatal mucosa or polymeric soft tissue substitutes are used when performing coronal advanced flap (CAF) or tunnel (TUN) surgical techniques. To evaluate which is the most successful approach, a literature review and meta-analysis were conducted. For the electronic search the National Library of Medicine, the Cochrane Oral Health Group Trials Register, EMBASE and WOS were used. Pooled data for the percentage of root coverage was collected and weighted means were calculated. Heterogeneity was determined using the Higgins (I2) statistic and a random-effects model was applied. Thirteen studies were included in the systematic review (12 randomized and 1 controlled clinical trials) in which both techniques (394 patients) were compared with a follow-up of 4 to 12 months. Galbraith and Baujat plots were used to control for the presence of potential outliers. After performing the meta-analysis (11 studies), the mean root coverage was similar when using the TUN or CAF techniques (p = 0.49). The only differences between the two were found for single recessions, where CAF offered a higher percentage of root coverage (mean difference = 4.98%; p = 0.006). There were no differences when applying an autograft or a polymeric substitute with either of the two tested surgical techniques (p = 0.445).

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Section: Discussionmentioning

confidence: 99%

Treating Gingival Recessions Using Coronally Advanced Flap or Tunnel Techniques with Autografts or Polymeric Substitutes: A Systematic Review and Meta-Analysis

et al. 2022

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“…Vertical releasing incisions were avoided as these may be difficult to perform on the lingual aspect of the mandibular incisors due to teeth inclination and quality of gingival tissues 12. More importantly, such incisions would compromise the lateral vascular supply at the surgical site, detrimental for wound healing,20 and also pose a risk of damaging the glandular or vascular structures 12. Difficult surgical access, poor quality of available tissue (thin gingival biotype and minimal KT) and risk of flap perforation limited us from preparing a split-thickness flap 11.…”

Section: Discussionmentioning

confidence: 99%

Use of a hybrid soft tissue autograft for gingival phenotype modification lingual to mandibular incisors

Yadav,

Makker,

Haidrus

et al. 2023

BMJ Case Rep

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Presence of adequate dimensions of keratinized/attached gingiva (KT/AG) and gingival thickness (GT) is considered necessary to maintain optimal periodontal health and long-term stability of gingival margin. Gingival phenotype modification therapies to increase these two dimensions (GT and KT/AG) on the buccal aspect of teeth have been widely reported, but the literature on lingual gingival augmentation is scarce. The purpose of this paper is to report the outcomes of a case treated with an envelope flap combined with a hybrid soft tissue autograft (subepithelial connective tissue graft with an epithelial collar) for phenotype modification of gingiva lingual to mandibular incisors presenting with thin gingiva (<1 mm) and lack of AG in tooth # 31 and 42. At 12 months follow-up, a substantial gain in KT, AG and GT along with partial root coverage was achieved.

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“…In the scientific literature, there are 16 systematic reviews with meta-analysis on this topic [ 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. The two main systematic reviews with meta-analysis are Atieh et al [ 37 ] and Huang et al [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

A New Matrix for Soft Tissue Management

Santis

Luciano

Pancera

et al. 2022

JCM

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Gingival recession is a mucogingival defect defined as the apical shifting of the gingival margin in relation to the CEJ. The use of connective tissue autografts allows for the obtention of very satisfactory results but is associated with undoubted disadvantages. The aim of the present work is to carry out a systematic review of the literature using a meta-analysis to investigate the clinical efficacy of xenogeneic collagen matrix (XCM) in the treatment of gingival recessions. This revision was carried out strictly following the guidelines published in the Cochrane Handbook. Thus, a meta-analysis was performed to calculate relative risks and standardized mean differences for each of the variables considered. The results of the meta-analysis show that CAF + CTG was statistically better than CAF + XCM in almost all the variables analyzed: complete root coverage (RR 0.46), mean root coverage (SMD −0.89), recession reduction (SMD −0.98), clinical attachment level (SMD −0.63) and gingival thickness (SMD −1.68). Meanwhile, CAF + XCM was slightly better than CAF alone in regard to: mean root coverage (SMD 0.51), recession reduction (SMD 0.47) and gingival thickness (SMD 0.56). It is possible to conclude that CAF + CTG still remains the gold standard in radicular coverage.

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Efficacy of modified coronally advanced flap in the treatment of multiple adjacent gingival recessions: a systematic review and meta-analysis

Cited by 5 publications

References 47 publications

Treating Gingival Recessions Using Coronally Advanced Flap or Tunnel Techniques with Autografts or Polymeric Substitutes: A Systematic Review and Meta-Analysis

Treating Gingival Recessions Using Coronally Advanced Flap or Tunnel Techniques with Autografts or Polymeric Substitutes: A Systematic Review and Meta-Analysis

Use of a hybrid soft tissue autograft for gingival phenotype modification lingual to mandibular incisors

A New Matrix for Soft Tissue Management

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