https://doi.org/10.21608/suodmj.2025.397307.1014

      https://www.preprints.org/manuscript/202411.1434/v1

Abstract:

Background : Gingival recession poses significant challenges in dental clinics and impacts almosthalf of the global population, predominantly affecting older adults. It occurs more frequently in the lower teeththan the upper teeth, which have thicker and more robust keratinized tissues. A range of surgical procedures,referred to as mucogingival surgeries, are employed to tackle this condition. These techniques, categorizedunder plastic surgery, strive to cover the exposed tooth roots, thereby diminishing sensitivity, facilitatinghygiene maintenance, and enhancing aesthetics affected by gingival recession. Aim of study: to underscore theefficacy of predicting maximum root coverage in treating gingival recession with coronal advancement flap(CAF) and autogenous subepithelial connective tissue grafts (CTG). This is achieved by comparing thepredetermined maximum root coverage (MRC) with the actual outcomes of root coverage surgical procedures.Methods: Patients with Gingival Recessions Type (RT)1 and RT2 were treated with Coronal advancement flapwith a connective tissue graft (CTG). The treatment protocol comprised scaling and root planing, along withroot surface conditioning. Subsequently, a surgical phase was conducted, involving a sub-epitheliumconnective tissue graft placed . This included the harvest of the graft from the palatal mucosa and its placementat the recipient site. Post-operative care instructions were provided, accompanied by a comprehensive follow-up schedule for one month. Results: there is no significant difference between the predetermine level of root coverageand the actual outcome postoperatively. In the case 1, full root coverage was attained, demonstrating both long-term stability and aesthetic achievement. Conversely, in the second case, root coverage reached 80% withattachment level gain and a gingival margin that was harmonious with adjacent teeth. It is deemed a successfulclinical result. Conclusion: The successful outcomes of combining Coronally Advanced Flap (CAF) withConnective Tissue Graft (CTG) in treating gingival recession of Miller class II and III cases have underscoredthe efficacy of predetermined assessments. These assessments enhance the clinician's ability to accuratelypredict the maximum root coverage achievable before surgery, which is vital for the success of regenerativetreatments. Further randomized clinical trials with extended follow-ups are required