Coronally Advanced Flap: The Post‐Surgical Position of the Gingival Margin Is an Important Factor for Achieving Complete Root Coverage

TLDR

Factors influencing root coverage outcomes are important for clinical decision making. This study examines whether the post‑surgical gingival margin position relative to the CEJ affects recession reduction and complete root coverage after coronally advanced flap. Sixty Miller Class I maxillary recessions were treated with CAF, and patient demographics and clinical measurements were analyzed using multiple linear and logistic regression. Baseline recession depth and a more coronal post‑surgical gingival margin both predict greater recession reduction and higher likelihood of complete root coverage. J Periodontol 2005;76:713‑722.

Abstract

Background: An assessment of the factors affecting the clinical outcome of root coverage procedures may be useful in clinical decision making. The aim of this study is to investigate whether the post‐surgical location of gingival margin relative to the cemento‐enamel junction (CEJ) can influence the recession reduction (RecRed) and complete root coverage (CRC) following coronally advanced flap procedure (CAF). Methods: Sixty patients, aged between 22 and 57 years, 15 males and 45 females, each showing maxillary buccal recessions (≥2 mm) identified as Miller's Class I were consecutively enrolled. All the defects were treated by CAF procedure from 2000 to 2003 by a single operator with more than 20 years of clinical experience. Age, gender, smoking habits, and type of tooth of each patient were recorded. In addition, the following clinical data were measured or computed: recession depth, width of keratinized tissue, probing depth, distance between incisal margin (IM) and CEJ, dental hypersensitivity, clinical attachment level, distance between IM and gingival margin (IMGM), distance between IM and mucogingival junction (IMMG), and the location of gingival margin relative to the CEJ following CAF procedure (GM 1 ). A multiple linear regression, and a logistic linear regression analyses were performed. Results: The recession depth at baseline (Rec T0 ) and the location of the gingival margin after suturing (GM 1 ) are positively correlated to recession reduction. Complete root coverage appeared to be influenced by GM 1 : the more coronal the level of the gingival margin after suturing (GM 1 ), the greater the probability of CRC. Conclusion: The location of the gingival margin relative to the cemento‐enamel junction following CAF procedure seems to affect CRC. J Periodontol 2005;76:713‐722 .