Aim: The aim of this long-term study was to compare the clinical outcomes of coronally advanced flap (CAF) alone versus coronally advanced flap plus connective tissue graft (CAF+CTG) in the treatment of multiple gingival recessions using a split-mouth design over 5 years of follow-up.
Materials and methods: A total of 13 patients (mean age 31.4 years) showing multiple bilateral gingival recessions were treated. On one side, CAF+CTG was used, while in the contra-lateral side, a CAF alone was applied. Clinical outcomes were evaluated at the 6-month, 1-year and 5-year follow-ups.
Results: A total of 93 Miller class I, II and III gingival recessions were treated. In the CAF+CTG-treated sites, the baseline gingival recession was 3.6 +/- 1.3 mm, while in the CAF-treated sites, it was 2.9 +/- 1.3 mm (p=0.0034). No difference in terms of the number of sites with complete root coverage (CRC) was reported (OR=0.49, p=0.1772) at the 6-month follow-up. At the 5-year follow-up, CAF+CTG-treated sites showed a higher percentage of sites with CRC (52%) than CAF-treated sites (35%) (OR=3.94; p=0.0239). An apical relapse of the gingival margin in CAF-treated sites was observed while a coronal improvement of the margin was noted in CAF+CTG-treated sites between the 6-month and the 5-year follow-ups.
Conclusions: CAF+CTG provided better CRC than CAF alone in the treatment of multiple gingival recessions at the 5-year follow-up.