Factors associated to complete coverage of Miller class I and II gingival recessions

Authors

Keywords:

smokers, risk factor, gingival recession.

Abstract

Introduction: Gingival recession is one of the most common esthetic-functional defects of the oral cavity. It is characterized by exposure of the root surface due to displacement of the apical gingival margin to the cementoenamel junction. The literature about the topic reports a percentage of favorable root coverage of Miller class I and II gingival recessions. However, several studies do not report complete coverage, which has been associated to a number of factors. Objective: Identify the factors associated to complete coverage of Miller class I and II gingival recessions in teeth treated with coronally repositioned flap. Methods: A search was conducted in the databases PubMed, SciELO, Redalyc, Lilacs and Scopus. Of a total 105 studies retrieved, seven met the inclusion criteria. Data analysis and integration: The meta-analysis did not achieve conclusive results, due to the high heterogeneity of the studies. However, the following factors were identified: use of ethylenediaminetetraacetic acid (p < 0.0001), presence of adjacent keratinized tissue ≥ 2 mm (p = 0.019), initial gingival recession depth > 3 mm (p = 0.020) and patients who smoked more than 10 cigarettes a day (p < 0.05). Conclusions: Use of ethylenediaminetetraacetic acid, presence of keratinized tissue, recession depth and smoker patients were identified as possible factors involved in the complete coverage Miller class I and II gingival recessions in teeth treated with coronally repositioned flap.

Downloads

Download data is not yet available.

Author Biographies

Miguel Enrique Tafur Villa, Universidad Científica del Sur, Facultad de Odontología, Departamento de Periodoncia e Implantes. Lima, Perú.

Cirujano Dentista .

Especialista en Periodoncia e Implantes Dentales

Carmen Teresa Castro-Ruiz, Universidad Científica del Sur, Facultad de Odontología, Departamento de Periodoncia e Implantes. Lima, Perú.

Profesora del Postgrado de Periodoncia, Universidad Científica del Sur , Lima, Perú

Magíster  en Periodoncia

Doctorando en Periodoncia Universidad Federal Rio Grande do Sul, Brasil

Gerardo Mendoza Azpur, Universidad Científica del Sur, Facultad de Odontología, Departamento de Periodoncia e Implantes. Lima, Perú.

Chairman del Postgrado de Periodoncia, Universidad Científica del Sur , Lima, Perú

Magister  en Periodoncia

Doctorando en Periodoncia Universidad Federal Rio Grande do Sul, Brasil

References

Cairo F, Barootchi S, Tavelli L, Barbato L, Wang HL, Rasperini G, et al. Esthetic- and patient-related outcomes following root coverage procedures: A systematic review and network meta-analysis. J Clin Periodontol. 2020;10.1111/jcpe.13346. DOI: 10.1111/jcpe.13346

Ha DH, John Spencer A, Ju X, Do LG. Periodontal diseases in the Australian adult population. Aust Dent J. 2020;65(Suppl 1):S52-S58. DOI: 10.1111/adj.12765

Teixeira D, Zeola L, Machado A, Gomes R, Souza P, Mendes D, et al. Relationship between noncarious cervical lesions, cervical dentin hypersensitivity, gingival recession, and associated risk factors: a cross-sectional study. J Dent. 2018; 5712(18): 30180-5.

Levi P, Rudy R, Jeong N, Coleman D. Non-surgical Control of Periodontal Diseases: A Comprehensive Handbook. 1st Edition. German: Springer-Verlag Berlin Heidelberg; 2016. pp. 1-20.

Jati A, Furquim L, Consolaro A. Gingival recession: its causes and types, and the importance of orthodontic treatment. Dental Press J Orthod. 2016;21(3):18-29. DOI: 10.1590/2177-6709.21.3.018-09.oin

Santos F, Storrer C, Cunha E, Ulbrich L, Lopez C, Deliberador T. Comparison of conventional and semilunar coronally positioned flap techniques for root coverage in teeth with cervical abrasion restored with pink resin. Clin Cosmet Investig Dent. 2017;9(9):7-11. DOI: 10.2147/CCIDE.S119040

Bhat M, AlQahtani N, Khader M, Javali M, AlQahtani A. Knowledge and Interest in Treating Gingival Recession among Dental Practitioners in Saudi Arabia. Open Access Maced J Med Sci. 2019;7(1):139-42. DOI: 10.3889/oamjms.2019.033

Krishnakumar D, Mahendra J, Ari G, Perumalsamy R. A clinical and histological evaluation of platelet-rich fibrin and CGF for root coverage procedure using coronally advanced flap: A split-mouth design. Indian J Dent Res. 2019;30(6):970-4. DOI: 10.4103/ijdr.IJDR_16_18

Seong J, Bartlett D, Newcombe R, Claydon N, Hellin N, West N. Prevalence of gingival recession and study of associated related factors in young UK adults. J Dent. 2018;5712(18):30163-5. DOI: 10.1016/j.jdent.2018.06.005

Fan J, Caton JG. Occlusal trauma and excessive occlusal forces: Narrative review, case definitions, and diagnostic considerations. J Periodontol. 2018;89(Suppl 1):S214-S222. DOI: 10.1002/JPER.16-0581

Carvalho BAS, Duarte CAB, Silva JF, Batista WWDS, Douglas-de-Oliveira DW, de Oliveira ES, et al. Clinical and radiographic evaluation of the Periodontium with biologic width invasion. BMC Oral Health. 2020;20(1):116. DOI: 10.1186/s12903-020-01101-x

Morris J, Campbell P, Tadlock L, Boley J, Buschang P. Prevalence of gingival recession after orthodontic tooth movements. Am J Orthod Dentofacial Orthop. 2017;151(5):851-9. DOI: 10.1016/j.ajodo.2016.09.027

Tepedino M, Franchi L, Fabbro O, Chimenti C. Post-orthodontic lower incisor inclination and gingival recession-a systematic review. Prog Orthod. 2018;19(17). DOI: 10.1186/s40510-018-0212-6

Lee JB, Baek SJ, Kim M, Pang EK. Correlation analysis of gingival recession after orthodontic treatment in the anterior region: an evaluation of soft and hard tissues. J Periodontal Implant Sci. 2020;50(3):146-58. DOI: 10.5051/jpis.2020.50.3.146

Covello F, Salerno C, Giovannini V, Corridore D, Ottolenghi L, Vozza I. Piercing and Oral Health: A Study on the Knowledge of Risks and Complications. Int J Environ Res Public Health. 2020;17(2):613. DOI: 10.3390/ijerph17020613

Jiménez F, Fernández M. Cobertura radicular con el procedimiento de colgajo de avance coronal en combinación con injerto de tejido conectivo autólogo: revisión bibliográfica y reporte de caso. Odovtos. 2017;19(2):25-32. DOI: 10.15517/ijds.v0i0.28745

Cairo F, Nieri M, Cincinelli S, Mervelt J, Pagliaro U. The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: an explorative and reliability study: Interproximal CAL for gingival recessions. J Clin Periodontol. 2011;38(7):661-6. DOI: 10.1111/j.1600-051x.2011.01732.x

Jepsen S, Caton J, Albandar J, Bissada N, Bouchard P, Cortellini P, et al. Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions: Classification and case definitions for periodontal manifestations of systemic diseases and developmental and acquired conditions. J Clin Periodontol. 2018;45:219-29. DOI: 10.1002/jper.17-0733

Bellver R, Martínez A, Gioia C, Caffesse R, Peñarrocha M. Surgical treatment of localized gingival recessions using coronally advanced flaps with or without subepithelial connective tissue graft. Med Oral Patol Oral Cir Bucal. 2016;21(2):222-8. DOI: 10.4317/medoral.21043

George SG, Kanakamedala AK, Mahendra J, Kareem N, Mahendra L, Jerry JJ. Treatment of gingival recession using a coronally-advanced flap procedure with or without placental membrane. J Investig Clin Dent. 2018;9(3):e12340. DOI: 10.1111/jicd.12340

British Society of Periodontology. The Good Practitioner’s Guide to Periodontology Londres: British Society of Periodontology; 2016.

César Neto JB, Cavalcanti MC, Sekiguchi RT, Pannuti CM, Romito GA, Tatakis DN. Root Coverage for Single Deep Gingival Recessions: Outcomes Based on a Decision-Making Algorithm. Int J Dent. 2019;2019:1830765. DOI: 10.1155/2019/1830765

Zuhr O, Rebele SF, Vach K, Petsos H, Hürzeler MB; Research Group for Oral Soft Tissue Biology & Wound Healing. Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivate for root coverage: 2-year results of an RCT using 3D digital measuring for volumetric comparison of gingival dimensions. J Clin Periodontol. 2020;2020. DOI: 10.1111/jcpe.13328

Zucchelli G, Tavelli L, Ravid? A, Stefanini M, Suarez F, Wang H. Influence of tooth location on coronally advanced flap procedures for root coverage. J Periodontol. 2018;89(12):1428-41. DOI: 10.1002/jper.18-0201

Nanavati B, Jaydeepchandra M. Coronally positioned flap for root coverage: comparison between smokers and nonsmokers. J Int Oral Health. 2013;5(2): 21-7.

Guldener K, Lanzrein C, Eliezer M, Katsaros C, Stähli A, Sculean A. Treatment of single mandibular recessions with the modified coronally advanced tunnel or laterally closed tunnel, hyaluronic acid, and subepithelial connective tissue graft: a report of 12 cases. Quintessence Int. 2020;51(6):456-63. DOI: 10.3290/j.qi.a44492

Pati D, Lorusso LN. How to Write a Systematic Review of the Literature. HERD. 2018;11(1):15-30. DOI: 10.1177/1937586717747384

Buggapati L, Chava V. Effect of combination of ethylenediaminetetraacetic acid + tetracycline with coronally positioned flap in the treatment of gingival recession: a clinical study. J Indian Soc Periodontol. 2016;20(1):57-62. DOI: 10.4103/0972-124x.168488

De Oliveira D, Marques D, Aguiar I, Flecha O, Gonçalves P. Effect of surgical defect coverage on cervical dentin hypersensitivity and quality of life. J Periodontol. 2013;84(6):768-75. DOI: 10.1902/jop.2012.120479

de Sanctis M, Clementini M. Flap approaches in plastic periodontal and implant surgery: critical elements in design and execution. J Clin Periodontol. 2014;41(15):S108-22. DOI: 10.1111/jcpe.12189

Gulati M, Saini A, Anand V, Govila V. Esthetic dentistry for multiple gingival recession cases: Coronally advanced flap with bracket application. J Indian Soc Periodontol. 2016;20(2):207-10. DOI: 10.4103/0972-124X.175178

Tonetti M, Jepsen S. Clinical efficacy of periodontal plastic surgery procedures: consensus report of Group 2 of the 10th European Workshop on Periodontology. J Clin Periodontol. 2014;41(15):S36-43. DOI: 10.1111/jcpe.12219

Falabella M, Alvarenga F, Segalla K, Adâo S, Silva-Boghossian CM. Treatment of gingival recession in 2 surgical stages: free gingival graft plus coronally positioned flap. Gen Dent. 2018;66(1):58-61.

Hussain S, Khan F. Five-year follow-up of a coronally advanced flap over grafted bone and restorative composite in maxillary recession defect. J Coll Physicians Surg Pak. 2017;27(6):370-2.

Nassar C, da Silva W, Tonet K, Secundes M, Nassar P. Comparing semilunar coronally positioned flap to standard coronally positioned flap using periodontal clinical parameters. Gen Dent. 2014;62(2):47-9.

Bansal A, Kulloli A, Kathariya R, Shetty S, Jain H, Raikar S. Comparative evaluation of coronally advanced flap with and without bioactive glass putty in the management of gingival recession defects: a randomized controlled clinical trial. J Int Acad Periodontol. 2016;18(1):7-15.

Barrella G, Kolbe M, Ribeiro F, Casati M, Casarin R, Cirano F, et al. Coronally advanced flap with two different techniques for the treatment of multiple gingival recessions: A pilot prospective comparative case series. Quintessence Int. 2016;47(1):39-50. DOI: 10.3290/j.qi.a34720

Debnath K, Chatterjee A. Evaluation of periosteum eversion and coronally advanced flap techniques in the treatment of isolated Miller's Class I/II gingival recession: A comparative clinical study. J Indian Soc Periodontol. 2018;22(2):140-9. DOI: 10.4103/jisp.jisp_5_18

Jepsen K, Stefanini M, Sanz M, Zucchelli G, Jepsen S. Long-term stability of root coverage by coronally advanced flap procedures. J Periodontol. 2017;88(7):626-33. DOI: 10.1902/jop.2017.160767

Zucchelli G, Mounssif I, Mazzotti C, Montebugnoli L, Sangiorgi M, Mele M, et al. Does the dimension of the graft influence patient morbidity and root coverage outcomes? A randomized controlled clinical trial. J Clin Periodontol. 2014;41(7):708-16. DOI: 10.1111/jcpe.12256

Reino D, Maia L, Novaes A, Souza S. Comparative study of two surgical techniques for root coverage of large recessions in heavy smokers. Int J Esthet Dent. 2015;10(3):456-67.

Tavelli L, Barootchi S, Ravid? A, Suárez-López Del Amo F, Rasperini G, Wang HL. Influence of suturing technique on marginal flap stability following coronally advanced flap: a cadaver study. Clin Oral Investig. 2019;23(4):1641-51. DOI: 10.1007/s00784-018-2597-5

Ahmadi R, Awwadi M, Moatazed S, Rezaei F, Hajisadeghi S. Comparison of acidic and neutral PH root conditioners prior to a coronally positioned flap to treat gingival recession. Dent Res J (Isfahan). 2014;11(3):309-15.

Kaval B, Renaud D, Scott D, Buduneli N. The role of smoking and gingival crevicular fluid markers on coronally advanced flap outcomes. J Periodontol. 2014;85(3):395-405. DOI: 10.1902/jop.2013.120685

Pini Prato G, Magnani C, Chambrone L. Long-term evaluation (20 years) of the outcomes of coronally advanced flap in the treatment of single recession-type defects. J Periodontol. 2018;89(3):265-74. DOI: 10.1002/JPER.17-0379

Tatakis D, Chambrone L. The effect of suturing protocols on coronally advanced flap root-coverage outcomes: a meta-analysis. J Periodontol. 2015;87(2):148-55. DOI: 10.1902/jop.2015.150394

Araújo R, Dourado M, Azoubel M, Santos R, Peloso E, Bittencourt S, et al. Effect of smoking on the periodontal microsurgery technique on the treatment of gingival recession. BJMHH. 2014;2(1):12-6. DOI: 10.17267/2317-3386bjmhh.v2i1.356

Shea B, Reeves B, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR-2: herramienta de evaluación crítica de revisiones sistemáticas de estudios de intervenciones de salud. BMJ 2017;358:j4008. DOI: 10.1136/bmj.j4008

Pussegoda K, Turner L, Garritty C, et al. Systematic review adherence to methodological or reporting quality. Syst Rev. 2017;6(1):131. Published 2017 Jul 19. DOI: 10.1186/s13643-017-0527-2

Published

2021-04-16

How to Cite

1.
Tafur Villa ME, Castro-Ruiz CT, Mendoza Azpur G. Factors associated to complete coverage of Miller class I and II gingival recessions. Rev Cubana Estomatol [Internet]. 2021 Apr. 16 [cited 2025 Feb. 5];58(2):e3154. Available from: https://revestomatologia.sld.cu/index.php/est/article/view/3154

Issue

Section

Review Article