Does placement of a connective tissue graft improve the outcomes of coronally advanced flap for coverage of single gingival recessions in upper anterior teeth? A multi-centre, randomized, double-blind, clinical trial

J Clin Periodontol. 2009 Jan;36(1):68-79. doi: 10.1111/j.1600-051X.2008.01346.x. Epub 2008 Nov 20.


Aims: This parallel-group, multi-centre, double-blind, randomized-controlled clinical trial was undertaken to compare the clinical outcomes and patient morbidity of coronally advanced flap (CAF) alone or in combination with a connective tissue graft (CAF+CTG) in single Miller Class I and II gingival recessions.

Material and methods: Three centres enrolled 85 patients with one recession each. Surgery was performed elevating a pedicle flap; 42 sites randomly received a graft under the flap. Measurements were taken by blind and calibrated examiners. Outcome measures included recession reduction, complete root coverage (CRC), intra-operative and post-operative morbidity, dentine sensitivity, and side effects.

Results: No differences were noted in the intra-operative and post-operative patient-related variables between the two groups. Surgical time was significantly shorter in the CAF group. Recession reduction was not statistically different between the two groups, even though a model showed a tendency towards improved outcomes in sites treated with CAF+CTG (adjusted difference 0.33 mm, 95% CI=-0.06 to 0.72, p=0.1002). Significantly greater probability of CRC was observed after CAF+CTG (adjusted OR=5.09, 95% CI=1.69-17.57, p=0.0033). Dentine hypersensitivity improved in both the groups.

Conclusions: Both treatments were effective in providing a significant reduction of the baseline recession and dentine hypersensitivity, with only limited intra-operative and post-operative morbidity and side effects. Adjunctive application of a CTG under a CAF increased the probability of achieving CRC in maxillary Miller Class I and II defects.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Combined Modality Therapy
  • Connective Tissue / transplantation*
  • Cuspid
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Gingival Recession / classification
  • Gingival Recession / surgery*
  • Gingivoplasty / methods*
  • Humans
  • Incisor
  • Maxilla
  • Middle Aged
  • Surgical Flaps*
  • Tooth Crown
  • Tooth Root
  • Treatment Outcome