Root coverage employing an envelope technique or guided tissue regeneration with a bioabsorbable membrane

Background: Different treatment modalities have been described for root cov erage in cases of gingival recession. The aim of the present study was to e valuate the postsurgical outcome of 2 modes of surgical root coverage of pr edominantly shallow, Class I or II, gingival recessions. Methods: Fourteen buccal recession sites in 13 patients were treated with f ree connective tissue grafts employing a modified envelope technique; 14 si tes in 9 patients were subjected to a coronally repositioned flap in combin ation with a bioabsorbable membrane. Immediately before surgery as well as after 6 months, gingival dimensions, i.e., width and thickness, as well as root coverage and attachment gain, were assessed to the next 0.1 mm employi ng a caliper, an ultrasonic device, and a pressure calibrated, computerized periodontal probe. Results: At the outset, mean recession depths amounted to 2.48 +/- 1.06 and 3.00 +/- 1.95 mm for patients treated with a free connective tissue graft and a bioabsorbable membrane, respectively. With the former technique, 80 /- 24% root surface could be covered after 6 months, while the latter resul ted in only 45 +/- 40% coverage. The contrast in reduction of recession wid th was even more pronounced (77 +/- 35% versus 18 +/- 37%). In both groups, an increase of gingival thickness of 0.6 to 0.7 mm was noticed. Conclusions: Small recessions may be covered more predictably with the modi fied envelope technique.