TY - JOUR
T1 - Root-coverage procedures for the treatment of localized recession-type defects
T2 - A Cochrane systematic review
AU - Chambrone, Leandro
AU - Sukekava, Flávia
AU - Araújo, Maurício G.
AU - Pustiglioni, Francisco E.
AU - Chambrone, Luiz Armando
AU - Lima, Luiz A.
PY - 2010/4
Y1 - 2010/4
N2 - Background: The purpose of this review is to evaluate the effectiveness of different root-coverage procedures in the treatment of recession-type defects. Methods: The Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE were searched for entries up to October 2008. There were no restrictions regarding publication status or the language of publication. Only clinical randomized controlled trials (RCTs) with a duration ≥6 months that evaluated recession areas (Miller Class I or II ≥3 mm) that were treated by means of periodontal plastic surgery procedures were included. Results: Twenty-four RCTs provided data. Only one trial was considered to be at low risk of bias. The remaining trials were considered to be at high risk of bias. The results indicated a significantly greater reduction in gingival recession and gain in keratinized tissue for subepithelial connective tissue grafts (SCTGs) compared to guided tissue regeneration (GTR) with bioabsorbable membranes (GTR bms). A significantly greater gain in keratinized tissue was found for enamel matrix protein compared to a coronally advanced flap (0.40 mm) and for SCTGs compared to GTR bms plus bone substitutes. Limited data exist on the changes of esthetic conditions as related to the opinions and preferences of patients for specific procedures. Conclusions: SCTGs, coronally advanced flaps alone or associated with other biomaterial, and GTR may be used as root-coverage procedures for the treatment of localized recession-type defects. In cases where root coverage and gain in keratinized tissue are expected, the use of SCTGs seems to be more adequate.
AB - Background: The purpose of this review is to evaluate the effectiveness of different root-coverage procedures in the treatment of recession-type defects. Methods: The Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE were searched for entries up to October 2008. There were no restrictions regarding publication status or the language of publication. Only clinical randomized controlled trials (RCTs) with a duration ≥6 months that evaluated recession areas (Miller Class I or II ≥3 mm) that were treated by means of periodontal plastic surgery procedures were included. Results: Twenty-four RCTs provided data. Only one trial was considered to be at low risk of bias. The remaining trials were considered to be at high risk of bias. The results indicated a significantly greater reduction in gingival recession and gain in keratinized tissue for subepithelial connective tissue grafts (SCTGs) compared to guided tissue regeneration (GTR) with bioabsorbable membranes (GTR bms). A significantly greater gain in keratinized tissue was found for enamel matrix protein compared to a coronally advanced flap (0.40 mm) and for SCTGs compared to GTR bms plus bone substitutes. Limited data exist on the changes of esthetic conditions as related to the opinions and preferences of patients for specific procedures. Conclusions: SCTGs, coronally advanced flaps alone or associated with other biomaterial, and GTR may be used as root-coverage procedures for the treatment of localized recession-type defects. In cases where root coverage and gain in keratinized tissue are expected, the use of SCTGs seems to be more adequate.
KW - Connective tissue
KW - Gingival recession
KW - Gingival recession/surgery
KW - Gingival recession/therapy
KW - Systematic review
KW - Tooth root/surgery
UR - http://www.scopus.com/inward/record.url?scp=77950678468&partnerID=8YFLogxK
U2 - 10.1902/jop.2010.090540
DO - 10.1902/jop.2010.090540
M3 - Review article
AN - SCOPUS:77950678468
SN - 0022-3492
VL - 81
SP - 452
EP - 478
JO - Journal of Periodontology
JF - Journal of Periodontology
IS - 4
ER -