Long-term stability of the mucogingival complex following guided tissue regeneration in gingival recession defects

The purpose of the present study was to evaluate the stability of soft tiss ue conditions in gingival recession defects treated with guided tissue rege neration (GTR). The study population was selected among those patients who had been treated with GTR procedures for Miller's class I or II, deep (grea ter than or equal to 3 mm), buccal gingival recession defects. Defects were included only when they had revealed recession depth reduction greater tha n or equal to 2 mm and root coverage greater than or equal to 60% at 6 mont hs following GTR treatment. These defects were regarded as successfully tre ated and scheduled for further monitoring. 20 patients, 11 male and 9 femal e, aged 23 to 57 years (mean age: 33.2 years), each contributing 1 defect, were selected. 9 patients were smokers (greater than or equal to 10 cigaret te per day). Recession depth (RD), probing depth (PD), clinical attachment level (CAL), and width of keratinized gingiva (KG) were assessed immediatel y before surgery, at 6 months post-surgery (baseline examination), and at 4 years post-surgery (4-year examination). At baseline examination, RD reduc tion was 3.6+/-0.9 mm (mean root coverage: 80%). CAL gain amounted to 4.2+/ -1.3 mm, 60% of the defects showing CAL gain greater than or equal to 4 mm. KG increased from 1.9+/-1.2 mm at presurgery examination to 3.1+/-0.9 mm a t baseline examination. At 4-year examination, no significant changes from baseline RD, CAL and KG recordings were observed. Differences in baseline-4 year changes between smokers and non-smokers were not statistically signif icant. The results of the present study demonstrate that clinical outcome a chieved following GTR procedure in gingival recession defects can be mainta ined over periods up to 4 years.