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Efficacy of periodontal plastic procedures in the treatment of multiple gingival recessions
Author(s) -
Graziani Filippo,
Gennai Stefano,
Roldán Silvia,
Discepoli Nicola,
Buti Jacpop,
Madianos Phoebus,
Herrera David
Publication year - 2014
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/jcpe.12172
Subject(s) - medicine , gingival recession , randomized controlled trial , dentistry
Objective To systematically review the efficacy of periodontal plastic procedures ( PPP ) in the treatment of multiple gingival recessions ( MGR ). Methods Randomized clinical trials ( RCT ) on MGR treatment with at least 6 months duration were identified through electronic databases and hand‐searched journals. Primary outcomes were complete root coverage ( CRC ) and percentage of root coverage ( PRC ). Weighted means and forest plots were calculated for all PPP . Subgroup analysis was performed according to the type of flap. A Bayesian network meta‐analysis ( NM ) on secondary outcomes was also performed. Results Nine trials including 208 subjects and 858 recessions were identified. CRC after PPP was 24–89%. Mean weighted PRC was 86.27% (95% CI 80.71–91.83; p < 0.01). Heterogeneity of the literature prevented inter‐techniques comparison. Coronally advanced flap ( CAF ) shows the higher variability in terms of CRC . Modified CAF and tunnel approaches show higher level of CRC . The NM suggests that CAF plus graft showed the higher probability of being the best treatment. Conclusions Limited evidence is available for MGR coverage. PPP are associated with high level of efficacy, in terms of PRC , and high variability of CRC . Indirect evidence indicates that CAF may benefit from newer variations of the technique and by the additional use of grafting.