Coronally advanced flap achieved higher esthetic outcomes without a connective tissue graft for the treatment of single gingival recessions: a 4-year randomized clinical trial

Objectives Limited long-term data are available when comparing the esthetic outcomes of coronally advanced flap (CAF) with or without a connective tissue graft (CTG). The aim of this study was to compare the 4-year esthetic outcomes of CAF vs CAF + CTG for the treatment of isolated maxillary gingival recessions. Material and methods Forty-eight patients were randomly assigned for treatment either with CAF (control;N= 24) or to CAF + CTG (test group;N= 24). Patients were followed after the surgery until the final evaluation. A professional esthetic evaluation was performed using the Root coverage Esthetic Score (RES). Recession reduction, mean root coverage, and complete root coverage were also evaluated. Results Forty-two patients completed the study at the 4-year recall. A significant recession reduction was evident at 4 years, without significant intergroup differences. The CAF group showed a statistically significant higher final RES compared with the CAF + CTG group (9.14 +/- 1.08 vs 7.25 +/- 1.29, respectively,p< 0.001). Regarding the individual components of RES, gingival margin and marginal tissue contour were significantly higher in the CAF group compared with that in the CAF + CTG group. Conclusions CAF presented with a significantly higher overall esthetic score than CAF + CTG, and in the individual RES components of marginal tissue contour and gingival margin after 4 years.

Automated summary

The study compared the 4-year esthetic outcomes of coronally advanced flap (CAF) versus CAF with a connective tissue graft (CTG) for the treatment of isolated maxillary gingival recessions. After 4 years, significant recession reduction was observed in both groups, with the CAF group showing a higher final esthetic score and better marginal tissue contour and gingival margin compared to the CAF + CTG group.