Abstract
To assess the difference in smile esthetic impact of Coronally Advanced Flap (CAF) with or without the adjunct of a collagen matrix (CMX) used as root coverage procedures. Subjects with esthetic demands showing multiple upper gingival recessions of at least 2 mm, without interproximal attachment loss and cervical abrasion no more than 1 mm were recruited and randomized to CAF plus CMX or CAF alone. The Smile Esthetic Index (SEI) was adopted to quantify the quality of the smile recorded at baseline and 12 months after treatment for each treatment group. In addition, between group difference in the SEI was calculated. 24 Patients were treated and analysed. At baseline, mean gingival recession depths were 2.3 ± 0.7 mm for Test group and 2.6 ± 1.0 mm for Control group. After 1 year, the residual recession depth was 0.3 ± 0.4 mm in the CAF + CMX group and 0.6 ± 0.3 mm in the control group. The SEI at baseline was 8.1 ± 1.0 and 7.9 ± 0.7 for Test and Control group, respectively. The between groups difference at 12 months in SEI was 0.4 (95% C.I. − 0.0 to 0.8, P = 0.0697). Twelve months after treatment, CAF + CMX provided a similar SEI compared to CAF alone and the adjunct of a collagen matrix did not show a different impact on the smile esthetic appearance.
Highlights
A single-mode survey of dental practices carried out by the American Academy of Cosmetic Dentistry (AACD) in 2015 indicated that 86% of patients elect cosmetic treatments to improve physical attractiveness and self-esteem [1]
Coronally Advanced Flap (CAF) + CMX provided a similar Smile Esthetic Index (SEI) compared to CAF alone and the adjunct of a collagen matrix did not show a different impact on the smile esthetic appearance
Considering the objective esthetic outcomes recorded by means of SEI, at baseline the values were 8.1 ± 1.0 and 7.9 ± 0.7 for Test and Control group, respectively
Summary
A single-mode survey of dental practices carried out by the American Academy of Cosmetic Dentistry (AACD) in 2015 indicated that 86% of patients elect cosmetic treatments to improve physical attractiveness and self-esteem [1]. Data shown that in terms of complete root coverage, at 6 months, the probability to obtain complete root coverage was significantly higher for CTG group than CMX cases [16] In another single-centre, superiority, assessor-blind clinical trial [20], CAF was tested in combination with CMX and compared to CAF alone. Results reported at 1 year showed similar clinical performances in terms of root coverage compared to CAF alone, but with the only significant difference in terms of gingival thickness in favour of CMX group. The aim of this study was to evaluate the difference in terms of esthetic of the smile using the Smile Esthetic Index between CAF plus CMX and CAF alone performed to treat multiple adjacent gingival recessions
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