Resumen de Coronally Positioned Flap for Root Coverage:: Poorer Outcomes in Smokers
Cléverson Oliveira Silva, Antonio Wilson Sallum, Antônio Fernando Martorelli de Lima, Dimitris N. Tatakis
Correspondence: Dr. Cléverson Oliveira Silva, Department of Prosthodontics and Periodontics, School of Dentistry at Piracicaba, University of Campinas, Av. Limeira 901, São Paulo, 13414-903 Brazil. Fax: 55-19-3412-5301; e-mail: silvaco@fop.unicamp.br.
Background: Gingival recession is significantly more common among smokers, while the relative outcome of various root coverage procedures in smokers, compared to non-smokers, is debatable. The objective of this study was to evaluate the influence of cigarette smoking on the outcome of coronally positioned flap (CPF) in the treatment of Miller Class I gingival recession defects.
Methods: Ten current smokers (≥10 cigarettes daily for at least 5 years) and 10 non-smokers (never smokers), each with one 2- to 3-mm Miller Class I recession defect in an upper canine or bicuspid, were treated with CPF. At baseline and 6 months, clinical parameters, probing depth (PD), clinical attachment level (CAL), recession depth (RD), and apico-coronal width of keratinized tissue (KT) were determined.
Results: Intragroup analysis showed that CPF was able to reduce RD and improve CAL in both groups (P <0.05). Intergroup analysis demonstrated that smokers presented greater residual RD at 6 months and lower percentage of root coverage (69.3% versus 91.3%; P <0.05). No smokers obtained complete root coverage compared to 50% of non-smokers (P <0.05).
Conclusions: Within the limits of the present study, it can be concluded that CPF provides benefits for both smokers and non-smokers in terms of root coverage of shallow Miller Class I recession defects. However, cigarette smoking negatively impacts the clinical outcomes, specifically residual recession, percent root coverage, and frequency of complete root coverage.
