Systematic review of periodontal plastic surgery in the treatment of multiple recession-type defects

Objectives: The objectives of this systematic review were (1) to evaluate results obtained with different periodontal plastic surgery procedures in the treatment of multiple recession-type defects and (2) to assess differences in results from randomized controlled trials and other types of studies (i.e., controlled clinical trials and case series). Materials and Methods: The MEDLINE, EMBASE and CENTRAL databases were searched up to June 2008 to identify randomized controlled trials, controlled clinical trials and case series with a follow-up period of at least 6 months for patients with multiple recession-type defects who were treated with periodontal plastic surgery. Results: Of 632 articles initially retrieved, only 16 were deemed suitable for more detailed analysis. Of these, only 4 case series met the inclusion criteria. Mean recession and clinical attachment level decreased substantially from baseline to final examination, and probing depth also declined. Mean width of keratinized tissue increased. Mean root coverage ranged from 94% to 98% over the 4 studies, and complete root coverage was achieved for 68% to 90% of patients in the 3 trials for which this variable was reported. Conclusions: Analysis of the limited information available in the dental literature showed improvements in clinical parameters with all of the periodontal plastic surgery procedures. Randomized controlled trials are needed to identify the indications for each surgical technique and any prognostic factors.