Resumen de Coronally Advanced Flap: The Post-Surgical Position of the Gingival Margin Is an Important Factor for Achieving Complete Root Coverage

Leonardo Muzzi, Dr. Giovan Paolo Pini Prato, Carlo Baldi, Michele Nieri, Debora Franceschi, Pierpaolo Cortellini, Carlo Clauser, Roberto Rotundo

• Coronally Advanced Flap: The Post-Surgical Position of the Gingival Margin Is an Important Factor for Achieving Complete Root Coverage Dr. Giovan Paolo Pini Prato Department of Periodontology, University of Florence, Florence, Italy.

  Carlo Baldi Private practice, Prato, Italy.

  Michele Nieri Department of Periodontology, University of Florence, Florence, Italy.

  Debora Franseschi Department of Periodontology, University of Florence, Florence, Italy.

  Pierpaolo Cortellini Department of Periodontology, Eastman Dental Institute, University College of London, London, U.K.

  Carlo Clauser Private practice, Florence, Italy.

  Roberto Rotundo Department of Periodontology, University of Florence, Florence, Italy.

  Leonardo Muzzi Department of Periodontology, University of Florence, Florence, Italy.

  Background: An assessment of the factors affecting the clinical outcome of root coverage procedures may be useful in clinical decision making. The aim of this study is to investigate whether the post-surgical location of gingival margin relative to the cemento-enamel junction (CEJ) can influence the recession reduction (RecRed) and complete root coverage (CRC) following coronally advanced flap procedure (CAF).

  Methods: Sixty patients, aged between 22 and 57 years, 15 males and 45 females, each showing maxillary buccal recessions (≥2 mm) identified as Miller's Class I were consecutively enrolled. All the defects were treated by CAF procedure from 2000 to 2003 by a single operator with more than 20 years of clinical experience. Age, gender, smoking habits, and type of tooth of each patient were recorded. In addition, the following clinical data were measured or computed: recession depth, width of keratinized tissue, probing depth, distance between incisal margin (IM) and CEJ, dental hypersensitivity, clinical attachment level, distance between IM and gingival margin (IMGM), distance between IM and mucogingival junction (IMMG), and the location of gingival margin relative to the CEJ following CAF procedure (GM1). A multiple linear regression, and a logistic linear regression analyses were performed.

  Results: The recession depth at baseline (RecT0) and the location of the gingival margin after suturing (GM1) are positively correlated to recession reduction. Complete root coverage appeared to be influenced by GM1: the more coronal the level of the gingival margin after suturing (GM1), the greater the probability of CRC.

  Conclusion: The location of the gingival margin relative to the cemento-enamel junction following CAF procedure seems to affect CRC. J Periodontol 2005;76:713-722.

  KEYWORDS: Coronally advanced flap procedure , gingival margin , gingival recession , prognostic factor , root coverage