Coronally advanced flap with and without connective tissue graft for the treatment of single maxillary gingival recession with loss of inter-dental attachment. A randomized controlled clinical trial

J Clin Periodontol. 2012 Aug;39(8):760-8. doi: 10.1111/j.1600-051X.2012.01903.x. Epub 2012 May 28.


Background: The aim of this randomized clinical trial (RCT) was to evaluate the adjunctive benefit of Connective Tissue Graft (CTG) to Coronally Advanced Flap (CAF) for the treatment of gingival recession associated with inter-dental clinical attachment loss equal or smaller to the buccal attachment loss (RT2).

Material and methods: A total of 29 patients with one recession were enrolled; 15 patients were randomly assigned to CAF+CTG while 14 to CAF alone. Measurements were performed by a blind and calibrated examiner. Outcome measures included complete root coverage (CRC), recession reduction (RecRed), Root coverage Esthetic Score (RES), intra-operative and post-operative morbidity, and root sensitivity.

Results: After 6 months, CAF+CTG resulted in better outcomes in terms of CRC (adjusted OR = 15.51, p = 0.0325) than CAF alone. CRC was observed in >80% of the cases treated with CAF+CTG when the baseline amount of inter-dental CAL was ≤ 3 mm. No difference was detected in term of RecRed. CAF+CTG was associated with longer surgical-time (p < 0.0001), higher number of days with post-operative morbidity (p = 0.0222) and the need for a greater number of analgesics (p = 0.0178) than CAF alone. No difference for final RES score was detected (p = 0.1612).

Conclusion: Both treatments can provide CRC in single gingival recession with inter-dental CAL loss. The application of CTG under CAF resulted in predictable CRC when inter-dental CAL was ≤ 3 mm.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Analgesics / therapeutic use
  • Connective Tissue / transplantation
  • Dentin Sensitivity / etiology
  • Esthetics, Dental
  • Female
  • Follow-Up Studies
  • Gingiva / transplantation*
  • Gingival Recession / pathology
  • Gingival Recession / surgery*
  • Humans
  • Intraoperative Complications
  • Male
  • Maxilla
  • Middle Aged
  • Operative Time
  • Periodontal Attachment Loss / pathology
  • Periodontal Attachment Loss / surgery*
  • Periodontal Index
  • Periodontal Pocket / pathology
  • Periodontal Pocket / surgery
  • Postoperative Complications
  • Radiography, Bitewing
  • Surgical Flaps / classification*
  • Time Factors
  • Tooth Root / surgery
  • Treatment Outcome


  • Analgesics