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Oral Surgery Periodontics Supporting Your Practice

How effective are periodontal plastic surgery procedures in the treatment of localized facial gingival recessions? A systematic review

Dentist Team At WorkThis summary is based on the article published in the Journal of Clinical Periodontology: Efficacy of periodontal plastic surgery procedures in the treatment of localized facial gingival recessions. A systematic review (April 2014)

Cairo F, Nieri M, Pagliaro U.




  • The treatment of gingival recessions with periodontal plastic surgery procedures is possible request in modern dentistry (1).
  • The ultimate goal of these procedures is the complete root coverage (CRC) and pleasant aesthetic outcomes (2, 3).

Purpose of the Review

The aim of this Systematic Review was to assess the clinical efficacy of periodontal plastic surgery procedures in the treatment of localized gingival recessions with or without inter-dental clinical attachment loss (iCAL).

Main Findings

  • Coronally Advanced Flap (CAF) procedures alone or with Connective Tissue Graft (CTG), Enamel Matrix
  • Derivative (EMD) are supported by large evidence in modern periodontal plastic surgery.
  • CAF+CTG achieved the best clinical outcomes in single gingival recessions with or without iCAL.
  • Coronally Advanced Flap plus Connective Tissue Graft is more effective than CAF to obtain root coverage at single gingival recession with no loss of interdental attachment.
  • Multiple combinations, using more than a single graft/biomaterial under the flap, usually provide similar or less benefits than simpler, control procedures in term of root coverage outcomes


  1. Buti, J., Baccini, M., Nieri, M., La Marca, M. & Pini-Prato, G. P. (2013) Bayesian network meta-analysis of root coverage procedures: ranking efficacy and identification of best treatment. Journal of Clinical Periodontology 40, 372–386.
  2. Cairo, F., Rotundo, R., Miller, P. D. & Pini Prato, G. P. (2009) Root coverage esthetic score: a system to evaluate the esthetic outcome of the treatment of gingival recession through evaluation of clinical cases. Journal of Periodontology 80, 705–710.
  3. Cairo, F., Nieri, M., Cattabriga, M., Cortellini, P., De Paoli, S., De Sanctis, M., Fonzar, A., Francetti, L., Merli, M., Rasperini, G., Silvestri, M., Trombelli, L., Zucchelli, G. & Pini-Prato, G. P. (2010) Root coverage esthetic score after treatment of gingival recession: an interrater agreement multicenter study. Journal of Periodontology 81, 1752–1758.


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1 Comment

  1. Dr. Sheryl P. Lipton September 23, 2014

    Thank you for sharing this review–and I have not read the articles!!
    I am finding that when i send patients out for root coverage, oftentimes the roots are still exposed and/or over time, the recession re-appears at what appears to be the original level.
    I’d love to know, on a long term basis, what percentage of teeth retain their coverage and for how long; and, should be expect continued recession post surgery and at what rate??


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