Root Coverage Effectiveness of Subepithelial Connective Tissue Graft
Abstract:
Several periodontal plastic surgical techniques have been proposed to obtain root coverage. All of these procedures are able to provide significant root coverage for Miller class I and II recession defects. However, only the subepithelial connective tissue graft in conjunction with a coronally advanced flap appears to be consistently effective across all the clinical parameters. It is therefore currently considered the gold standard in gingival recession therapy. The major shortcomings of connective tissue graft procedures include the patient’s morbidity associated with the second surgical site and the limited availability of palatal donor tissue. For these reasons, alternative procedures using membranes, enamel matrix derivative, platelet rich fibrin and soft tissue substitutes such as acellular dermal matrix and xenogeneic dermal matrix have been introduced. When comparing clinical results, the use of these different alternatives is associated with inferior outcomes. Other drawbacks can be related to their cost and ethical concerns. Moreover, there is also limited available data focusing on the long-term outcomes following treatment with these biomaterials. In conclusion, the clinician’s decision should take into account the clinical situation, the availability of palatal donor tissue as well as the patient’s preferences.
