Predictor factors for long‐term outcomes stability of coronally advanced flap with or without connective tissue graft in the treatment of single maxillary gingival recessions: 9 years results of a randomized controlled clinical trial

Rasperini, Giulio; Acunzo, Raffaele; Pellegrini, G; Pagni, Giorgio; Tonetti, Maurizio S.; Prato, Giovan Paolo Pini; Cortellini, Pierpaolo

doi:10.1111/jcpe.12932

Cited by 62 publications

(110 citation statements)

References 39 publications

(65 reference statements)

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“…Then, a total of 38 articles were selected for full‐text screening. Finally, 15 RCTs (Abolfazli, Saleh‐Saber, Eskandari, & Lafzi, ; Amarante, Leknes, Skavland, & Lie, ; Bittencourt et al., ; Cortellini et al., ; Del Pizzo, Zucchelli, Modica, Villa, & Debernardi, ; Fernandes‐Dias et al., ; Jepsen et al., , ; Kuis et al., ; Leknes et al., ; McGuire & Nunn, ; McGuire & Scheyer, , ; McGuire, Scheyer, & Nunn, ; McGuire, Scheyer, & Schupbach, ; McGuire, Scheyer, & Snyder, ; Nizam, Bengisu, & Sonmez, ; Pini Prato et al., ; Pini‐Prato et al., ; de Queiroz Cortes, Sallum, Casati, Nociti, & Sallum, ; Rasperini et al., ; Rosetti, Marcantonio, Zuza, & Marcantonio, ; Santamaria et al., ) fulfilled the inclusion criteria. The rest 23 studies were excluded for different reasons (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Three RCTs (Bittencourt et al., ; Kuis et al., ; Rasperini et al., ) directly compared CAF + CTG and CAF alone. Both the short‐term and long‐term results of CRC were significantly in favour of CAF + CTG.…”

Section: Discussionmentioning

confidence: 99%

“…Technique‐related factors including operation process and operator skills could have an immediate and essential impact on the predictability and the overall efficacy of the surgery (Zuhr, Rebele, Cheung, Hurzeler, & Wound, ). Site‐related factors may also have an influence on the stability, such as width of keratinized tissue band (Jepsen et al., ; Kuis et al., ; Rasperini et al., ), thickness of keratinized tissue (Bittencourt et al., ; de Queiroz Cortes et al., ) and non‐caries cervical lesion (Rasperini et al., ). At the patient level, smoking (Leknes et al., ), ageing (Pini Prato et al., ) and oral hygiene habits (Rasperini et al., ) appear to be relevant in the maintenance of root coverage.…”

Section: Discussionmentioning

confidence: 99%

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Long‐term stability of root coverage procedures for single gingival recessions: A systematic review and meta‐analysis

Dai

Huang

Ding

et al. 2019

J Clinic Periodontology

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Aim To evaluate the long‐term (≥2 years) stability of root coverage procedures for single gingival recessions. Materials and Methods A complete literature search was performed up to July 2018. Randomized controlled trials (RCTs) following ≥2 years were selected. Primary outcomes were complete root coverage (CRC) and mean root coverage (MRC). Secondary outcomes were width of keratinized tissue (KTW) and patient‐centred parameters. Meta‐analysis was conducted when possible. Results A total of fifteen RCTs were included. The results demonstrated significantly higher MRC in short‐term than long‐term after coronally advanced flap (CAF; 7.29%, p = 0.006). When CAF combined with connective tissue graft (CTG), no significant difference was observed in CRC or MRC for short‐term versus long‐term (1.00, p = 0.97; 2.35%, p = 0.09), and it resulted in better long‐term efficacy than CAF alone in terms of CRC (0.69, p = 0.0006) and KTW (−0.63 mm, p = 0.04). For CAF plus enamel matrix derivative, the meta‐analysis showed no significant difference between the short‐term and long‐term results of CRC (1.26, p = 0.21). Conclusions CAF alone could result in decreased postoperative percentage of root coverage with time. CAF + CTG could maintain long‐term stability and result in better root coverage outcomes than CAF.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Long‐term stability of root coverage procedures for single gingival recessions: A systematic review and meta‐analysis

Dai

Huang

Ding

et al. 2019

J Clinic Periodontology

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“…Several surgical procedures have been developed to treat GR and increase the amount of keratinized tissue (KT). Short‐term studies show (i.e., 6 to 12 months) significant recession reduction (up to complete root coverage) and KT gain may be achieved with root coverage therapy whereas long‐term studies reveal that the gingival margin remains stable for most of the sites/patients . In addition, several root coverage techniques, such as free gingival graft (FGG) and coronally advanced flap plus subepithelial connective tissue graft (SCTG), provide a significant increase of KT after surgery, and improve the toothbrushing procedures …”

Section: Introductionmentioning

confidence: 99%

Effect of gingival augmentation procedure (free gingival graft) on reducing the risk of non‐carious cervical lesions: A 25‐ to 30‐year follow‐up study

Agudio

Selvaggi

Pini‐Prato³

2019

Journal of Periodontology

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Background The aim of this long‐term case series was to assess the development/prevalence of non‐carious cervical lesions (NCCLs) at sites that have and have not been treated with gingival augmentation following free gingival graft (FGG). Methods Fifty‐two patients had at least one test and one control site: 1) test site showing absence of attached gingiva (AG) associated with gingival recession (GR) treated with FGG; and 2) contralateral site with or without AG. Patient/tooth/site‐associated variables were recorded for each tooth/site at baseline (T0), 12 months after surgery (T1), during the follow‐up period (T2) (15 to 20 years), and at the end of the follow‐up period (T3) over 25 to 30 years. Mixed‐effects logistic regression was used throughout the study. Results Forty‐nine patients/130 sites were available for analysis at T2 whereas 44 patients/120 sites at T3. Twenty‐two NCCLs >0.5 mm were restored in the test sites and in 35 in the untreated sites. The development of NCCL over time appeared associated with sites with attached KT <2 mm (i.e., odds ratio [OR]: 3.80 [P = 0.045] and 3.47 [P = 0.046], 15‐ to 20‐ and 20‐ to 30‐year follow‐ups, respectively), as well as to teeth presenting a thin/non‐modified periodontal phenotype (i.e., OR: 3.53 [P = 0.037] and 5.51 [P = 0.008], 15‐ to 20‐ and 20‐ to 30‐year follow‐ups, respectively). Conclusions Periodontal phenotype modification achieved by FGG may prevent the development/progression of NCCL. Evidence suggests that the thickness and width of the AG had a direct influence on the need of restoring these lesions during the 25‐ to 30‐year observation period.

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“…In agreement with previous studies, the addition of CTG was able to enhance the outcomes of CAF (94.13% ± 12.7% versus 87.4% ± 18.7% for mRC; and 78.9% versus 63.1% for CRC). Among the advantages of CTG compared with treatment with flap alone, it has been speculated that the CTG acts as a biological scaffold that enhances flap adaptation to the root surface, providing added increased soft tissue thickness which has been correlated with higher CRC and long‐term stability …”

Section: Discussionmentioning

confidence: 99%

The influence of tooth location on the outcomes of multiple adjacent gingival recessions treated with coronally advanced flap: A multicenter re‐analysis study

Zucchelli

Tavelli

Barootchi

et al. 2019

Journal of Periodontology

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Background Tooth location has been shown to play a significant role on root coverage outcomes. However, whether this has an impact on the outcomes of coronally advanced flap (CAF) for treating multiple adjacent gingival recessions (MAGRs) remains to be determined. The aim of this study was to investigate the impact of tooth location, flap design, and flap extension on the outcomes of MAGRs following CAF with or without a connective tissue graft (CTG). Methods A re‐analysis of six previously published clinical trials evaluating the outcomes of CAF in the treatment of MAGRs was performed using mixed regression and logistics to assess the influence of potentially influential factors on the treatment outcomes. Results Six hundred and nine MAGRs in 166 patients were evaluated. The anterior maxilla (second sextant) was associated to the highest mean root coverage (mRC) and complete root coverage (CRC) outcome (P < 0.05). In addition, the maxillary teeth showed significantly greater mRC and CRC than teeth in the mandible (with the lower anterior [fifth sextant] showing the lowest outcomes) (P < 0.05). A higher mRC was observed for the anterior teeth compared with posterior dentition (P < 0.05). While CAF + CTG achieved better results than CAF alone, no differences were found when the flap was performed with or without vertical releasing incisions (P > 0.05). Lastly, teeth in the distal part of the flap showed lower mRC and CRC than teeth in the central or mesial position (P < 0.05). Conclusions Tooth location was found to play a key role in determining the amount of root coverage achievable, with maxillary canines and incisors being associated with the highest outcomes compared with other sextants. Maxillary MAGRs showed greater mRC and CRC than mandibular MAGRs.

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Predictor factors for long‐term outcomes stability of coronally advanced flap with or without connective tissue graft in the treatment of single maxillary gingival recessions: 9 years results of a randomized controlled clinical trial

Abstract: Both treatment modalities demonstrated stability over time. Additional use of CTG provided a greater increase in KT. The presence of NCCL negatively affected CRC and REC.

Cited by 62 publications

References 39 publications

Long‐term stability of root coverage procedures for single gingival recessions: A systematic review and meta‐analysis

Long‐term stability of root coverage procedures for single gingival recessions: A systematic review and meta‐analysis

Effect of gingival augmentation procedure (free gingival graft) on reducing the risk of non‐carious cervical lesions: A 25‐ to 30‐year follow‐up study

The influence of tooth location on the outcomes of multiple adjacent gingival recessions treated with coronally advanced flap: A multicenter re‐analysis study

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