Coronally advanced flap with two different techniques for the treatment of multiple gingival recessions: A pilot prospective comparative case series

Objectives: The objective of this prospective study was to compare the clinical outcomes of coronally advanced flap (CAF) using two different surgical strategies in the treatment of multiple gingival recessions. Method and Materials: Ten patients presenting with a total of 81 Miller class I gingival recessions were included. Recessions were randomly treated according to a split-mouth design by means of CAF with oblique interdental incisions (OBL technique), or CAF with horizontal interdental incisions (HOR technique). Marginal gingival recession (REC), clinical attachment level (CAL), pocket probing depth (PPD), height of keratinized tissue (HKT), and thickness of keratinized tissue (TKT) were measured at baseline, and 3 and 6 months after treatment. Patient-centered outcomes concerning morbidity and improvement in the esthetic appearance were recorded using a visual analog scale (VAS). Results: Both groups showed significant reductions in REC and gains in CAL throughout the study (P .05). At 3 months, OBL-treated sites showed greater root coverage than HOR-treated sites (P .05), although no intergroup differences were observed at 6 months (P > .05). There was an increase in HKT only in the OBL group at 6 months from baseline (P .05). No differences between therapies were revealed concerning morbidity (P > .05), whereas a higher satisfaction with the esthetic appearance was reported for the OBL technique 6 months postsurgery (P .05). Conclusion: Although both surgical approaches may provide satisfactory root coverage, use of the OBL technique promoted additional benefits in terms of esthetic perception after the management of multiple gingival recessions. Keywords: controlled clinical trial, gingival recession, operative, patient outcome assessment, surgical procedures