Comparative clinical study between two bilaminarprocedures for the treatment of gingival recessions: a4-year study

Aim: This prospective 4-year study compares two bilaminar techniques: connective tissue graft (CTG) and coronally advanced flap (CAF) with or without vertical releasing incisions (V or nV) in achieving root coverage. Materials and methods: Thirty non-smoking patients with a Miller Class I or II gingival recession were selected for treatment using a bilaminar technique. The patients were randomly assigned to two groups of 15 patients each and treated by means of CTG + CAF/V (group A) or CTG + CAF/nV (group B). The parameters scored at baseline (T0), at 1 and 4 years postsurgery (T1 and T2) were: recession depth (R), pocket depth, clinical attachment level (CAL) and keratinised tissue width (KT). Aesthetic assessments were made at T1 and T2 by a clinician and by the patients through interviews. Results: At T0 mean R-values were 3.87 mm (group A) and 3.67 mm (group B). Mean root coverage (MRC) went from 89.9% (T1) to 87.7% (T2) in group A while MRC changed from 93.5% (T1) to 94.8% (T2) in group B. From T0 toT1/T2 in both groups R reduction, CAL gain and KT increase were statistically significant (P < 0.0001) without differences between the groups. Aesthetic results showed significant differences between the groups such as better tissue blending (T1 P = 0.0008, T2 P = 0.0481) and absence of scar formation (P < 0.0001) in group B. Conclusions: Both techniques produced similar and stable clinical results over a 4-year study time. However, aesthetic assessments showed better outcomes in group B.