Hp. Muller et al., Failure of root coverage of shallow gingival recessions employing GTR and a bioresorbable membrane, INT J PER R, 21(2), 2001, pp. 171-181
Citations number
35
Categorie Soggetti
Dentistry/Oral Surgery & Medicine
Journal title
INTERNATIONAL JOURNAL OF PERIODONTICS & RESTORATIVE DENTISTRY
The aim of the present study was to compare the postsurgical outcome of two
different modes of surgical root coverage of predominantly shallow, Class
I or II, gingival recessions. Fourteen facial recessions in nine patients w
ere subjected to a coronally repositioned flap in combination with a biores
orbable membrane, and 14 sites in 13 patients were treated with a connectiv
e tissue graft employing an envelope technique. Immediately before surgery
and after 6 and 12 months, gingival dimensions as well as root coverage and
attachment gain were assessed. At baseline, mean recession depths amounted
to 2.77 +/- 1.67 mm and 2.49 +/- 7.07 mm for patients treated with a biore
sorbable membrane and a free connective tissue graft, respectively. Accepta
ble and stable root coverage of 81% to 82% of baseline recession depth and
78% of its width was achieved by grafting. In contrast, guided tissue regen
eration (GTR) resulted in only 50% coverage of recession depth and, after 1
2 months, only 11% of its width (P < 0.01). Logistic regression revealed th
at the odds of obtaining success, ie, at least 80% root coverage, were 3.3
times greater in cases treated with a connective tissue graft (P < 0.05). I
n addition, the odds ratio was 2.3 in cases of recessions below 2.5 mm comp
ared to deeper recessions and 2 at canines compared to premolars. It was co
ncluded that shallow recessions in the 1.5 to 3.5 mm range should not be tr
eated with GTR. In these situations, predictable results are achieved with
free connective tissue grafts employing an envelope technique.