Long-term stability of root coverage procedures for single gingival recessions: A systematic review and meta-analysis.

Abstract

To evaluate the long-term (≥2years) stability of root coverage procedures for single gingival recessions. A complete literature search was performed up to July 2018. Randomized controlled trials (RCTs) following ≥2years were selected. Primary outcomes were complete root coverage (CRC) and mean root coverage (MRC). Secondary outcomes were width of keratinized tissue (KTW) and patient-centred parameters. Meta-analysis was conducted when possible. A total of fifteen RCTs were included. The results demonstrated significantly higher MRC in short-term than long-term after coronally advanced flap (CAF; 7.29%, p=0.006). When CAF combined with connective tissue graft (CTG), no significant difference was observed in CRC or MRC for short-term versus long-term (1.00, p=0.97; 2.35%, p=0.09), and it resulted in better long-term efficacy than CAF alone in terms of CRC (0.69, p=0.0006) and KTW (-0.63mm, p=0.04). For CAF plus enamel matrix derivative, the meta-analysis showed no significant difference between the short-term and long-term results of CRC (1.26, p=0.21). CAF alone could result in decreased postoperative percentage of root coverage with time. CAF+CTG could maintain long-term stability and result in better root coverage outcomes than CAF.