Can subepithelial connective tissue grafts be considered the gold standard procedure in the treatment of Miller Class I and II recession-type defects?

Chambrone, Leandro; Chambrone, Daniela; Pustiglioni, Francisco E.; Chambrone, Luiz A.; Lima, Luiz A.

doi:10.1016/j.jdent.2008.05.007

« Previous Next »Journal of Dentistry
Volume 36, Issue 9 , Pages 659-671, September 2008

Can subepithelial connective tissue grafts be considered the gold standard procedure in the treatment of Miller Class I and II recession-type defects?

Leandro Chambrone
- Discipline of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
- Corresponding author at: Rua Cristianópolis, 220 – Mooca, 03128030 São Paulo, SP, Brazil. Tel.: +55 11 6965 3590; fax: +55 11 6965 3590.
Daniela Chambrone
- Discipline of Periodontics, Faculty of Dentistry, Methodist University of São Paulo, São Bernardo do Campo, Brazil
Francisco E. Pustiglioni
- Discipline of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
Luiz A. Chambrone
- Discipline of Periodontics, Faculty of Dentistry, Methodist University of São Paulo, São Bernardo do Campo, Brazil
Luiz A. Lima
- Discipline of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil

Received 13 March 2008; received in revised form 14 May 2008; accepted 16 May 2008.

Abstract

Objectives

The objective of this systematic review was to answer the following question: ‘Can subepithelial connective tissue grafts (SCTG) be considered the gold standard procedure in the treatment of recession-type defects?’

Data and source

An electronic search (MEDLIINE, EMBASE and CENTRAL) for randomized controlled clinical trials with at least 6 months’ follow-up comparing SCTG with other procedures for the treatment of gingival recession was performed up to December 2007.

Study selection

To be eligible to this review patients had to present a diagnosis of gingival recession with the following characteristics: (a) recession areas selected for treatment classified as Miller [Miller Jr PD. A classification of marginal tissue recession. International Journal of Periodontics & Restorative Dentistry 1985;5:8–13.] Class I or Class II of at least 2mm; (b) recession areas containing teeth with no caries or restorations; and (c) at least 10 participants per group at final examination. From a total of 568 references, 23 studies were considered relevant. The results indicated a statistically significant greater reduction in gingival recession for SCTG, when compared to acellular dermal matrix grafts and guided tissue regeneration with resorbable membranes (GTR rm). For clinical attachment level changes, differences between all groups were not significant. For changes in the keratinized tissue (KT), the results showed a statistically significant gain in the width of KT for SCTG when compared to GTR rm.

Conclusion

The results of this review show that subepithelial connective tissue grafts provided significant root coverage, clinical attachment and keratinized tissue gain. Overall comparisons allow us to consider it as the ‘gold standard’ procedure in the treatment of recession-type defects.

Keywords: Gingival recession, Gingival recession/surgery, Gingival recession/therapy, Connective tissue, Tooth root/surgery, Systematic review