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. 2022 Sep;93(9):1336-1352.
doi: 10.1002/JPER.22-0167. Epub 2022 May 12.

Does the subepithelial connective tissue graft in conjunction with a coronally advanced flap remain as the gold standard therapy for the treatment of single gingival recession defects? A systematic review and network meta-analysis

Leandro Chambrone  1   2   3   4 , João Botelho  1   5 , Vanessa Machado  1   5 , Paulo Mascarenhas  1 , José João Mendes  1 , Gustavo Avila-Ortiz  4
Affiliations

Does the subepithelial connective tissue graft in conjunction with a coronally advanced flap remain as the gold standard therapy for the treatment of single gingival recession defects? A systematic review and network meta-analysis

Leandro Chambrone et al. J Periodontol. 2022 Sep.

Abstract

Background: The aim of this systematic review and network meta-analysis (NMA) was to assess the efficacy of a bilaminar root coverage technique consisting of the combination of an autogenous subepithelial connective tissue graft (SCTG) and a coronally advanced flap (CAF) compared with the five most indicated alternative approaches for the treatment of single gingival recession defects (GRD).

Methods: The protocol of this PRISMA 2020-compliant systematic review was registered in PROSPERO (CRD42020221362). Three electronic databases were searched up to September 30, 2021 to identify randomized controlled trials that involved the treatment of single GRD without interproximal tissue loss via root coverage procedures. A frequentist NMA was conducted for complete root coverage (CRC), mean root coverage (MRC), and keratinized tissue width (KTW) changes.

Results: A total of 38 studies reporting on 830 patients and 1,265 GRD were included. SCTG + CAF was ranked as the most efficient treatment approach for MRC, CRC, and KTW gain at 6 and 12 months after surgery, except for MRC at the 12-month follow-up where enamel matrix derivative plus CAF exhibited superior results.

Conclusions: SCTG + CAF can be considered the gold standard for the treatment of single GRD.

Keywords: gingival recession; surgery; surgical flaps; tissue grafts; wound healing.

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References

REFERENCES

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    1. Chambrone L, Salinas Ortega MA, Sukekava F, et al. Root coverage procedures for treating localised and multiple recession-type defects. Cochrane Database Syst Rev. Cochrane Oral Health Group. 2018;10:CD007161. https://doi.wiley.com/10.1002/14651858.CD007161.pub3. editor. Cochrane Database of Systematic Reviews [Internet]. cited 2021 Nov 5]. Available from
    1. Chambrone L, Ortega MAS, Sukekava F, et al. Root coverage procedures for treating single and multiple recession-type defects: an updated Cochrane systematic review. J Periodontol. 2019;90(12):1399-1422.
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