SUBEPITHELIAL CONNECTIVE-TISSUE GRAFTS IN THE TREATMENT OF GINGIVAL RECESSIONS - A COMPARATIVE-STUDY OF 2 PROCEDURES

THIRTY (30) CLASS I AND CLASS II RECESSIONS in 30 subjects were treate d with a subepithelial connective tissue graft procedure. In one group (15 sites), the surgery was carried out in a traditional fashion: the epithelial collar of the graft was preserved and left exposed (CTG gr oup). In the second group (15 sites), the epithelial collar of the gra ft was removed and the recession areas were conditioned with citric ac id. The graft was then sutured and completely immersed under the facia l flap which was coronally repositioned (CR group). Clinical assessmen ts included probing depth, probing attachment level, surface area of t he recession, and gingival width. These measurements were taken at bas eline and at 6 months. In addition, an esthetic evaluation was done. T he differences between treatments were not statistically significant e xcept for the augmentation of gingiva (P less than or equal to 0.05). Based on the midfacial measurements taken in the central area of the r ecession, the mean percentage of root coverage was 69.2%. In the CR gr oup, 3 of the 15 recessions exhibited complete root coverage; the ging ival augmentation was 65.5%. In the CTG group, 5 of the 15 recessions exhibited complete root coverage; the gingival augmentation was 94.4%. The mean surface area of root exposure was reduced from 13.82 mm(2) a nd 13.67 mm(2) to 2.15 mm(2) and 2.34 mm(2) for the CR group and the C TG group, respectively. One-hundred percent (100%) of good-to-moderate esthetic results were found by a panel of independent examiners; ther e was tendency toward better results in the CR group. The results of t his study indicate that partial success could be expected with subepit helial connective tissue grafting in Class I or Class II recession the rapy. It is suggested that the CR group procedure gives better estheti c results than the CTG group procedure. However, when larger augmentat ion with keratinized tissue is needed, the CTG group procedure is pref erred.