Single gingival recession associated with non‐carious cervical lesion treated by partial restoration and coronally advanced flap with or without xenogenous collagen matrix: A randomized clinical trial evaluating the coverage procedures and restorative protocol

Abstract

Background: Evaluate the use of collagen matrix (CM) as adjunctive to coronally advanced flap (CAF versus CAF + CM) to treat gingival recession (GR) associated with non-carious cervical lesion-combined defects (CDs).Methods: Sixty-two patients presenting 62 CDs (RT1 GR and non-carious cervical lesion (NCCLs) were randomly allocated to either CAF group (n = 31): partial restoration of the NCCL and CAF; or to CAF + CM group (n = 31): partial restoration of the NCCL and CAF associated with CM. Clinical, esthetic, patientcentered outcomes, and restorative parameters were assessed. Results: After 12 months, CD coverage were 55.2% for CAF and 54.4% for CAF + CM (P = 0.8). Recession reduction were 1.9 ± 0.8 mm for CAF and 2.0 ± 0.7 mm for CAF + CM (P = 0.6). CAF+CM resulted in higher increase in keratinized tissue (KT) width (CAF: 0.3 ± 0.7 mm; CAF + CM: 0.9 ± 0.8 mm; P = 0.004) and KT thickness gain (CAF: 0.1 ± 0.3 mm; CAF + CM: 0.7 ± 0.2 mm; P = 0.001). Both treatments presented low postoperative pain and resulted in esthetics improvements. In addition, no restoration was lost, 27.4% showed a reduction of the superficial polishing, and 8% showed marginal staining, but still clinically acceptable. Conclusion: Partial resin composite restoration (with the apical limit up to 1 mm of the estimated CEJ) and CAF alone or combined with CM are suitable for treating CDs. The use of CM provided additional benefits in terms of KT width and thickness gain. (NCT03341598).

Effectiveness of surgical root coverage on dentin hypersensitivity: A systematic review and meta‐analysis

“…Data for mean RecRed and KTW gain were available for all studies. Seven studies reported TKT gain (Fernandes-Dias et al, 2015;Santamaria et al, 2016Santamaria et al, , 2017Santamaria et al, , 2018Santamaria et al, , 2021Cairo et al, 2020;Mathias-Santamaria et al, 2021). Ten studies assessed the percentage of mean RC (McGuire & Nunn, 2003;Cortellini et al, 2009;Cairo et al, 2012;Fernandes-Dias et al, 2015;Santamaria et al, 2017Santamaria et al, , 2018Santamaria et al, , 2021Clementini et al, 2018;Nahas et al, 2019;Mathias-Santamaria et al, 2021).…”

“…Table 2 depicts the general characteristics of the included studies. Two RCTs were conducted with split‐mouth design (McGuire & Nunn, 2003; Nahas et al, 2019) and 11 were conducted with a parallel group (Cortellini et al, 2009; Cairo et al, 2012, 2020; Fernandes‐Dias et al, 2015; Santamaria et al, 2016, 2017, 2018, 2021; Clementini et al, 2018; Tonetti et al, 2018; Mathias‐Santamaria et al, 2021).…”

“…The studies used different surgical RC techniques. Two studies reported data using coronally advanced flap (CAF) with or without CTG (Cortellini et al, 2009; Cairo et al, 2012), nine studies assessed the contribution of an adjuvant (enamel matrix derivative, low‐level laser therapy, resin restoration, and xenogeneic collagen matrix [XCM], xenogeneic acellular dermal matrix) (McGuire & Nunn, 2003; Fernandes‐Dias et al, 2015; Santamaria et al, 2016, 2018, 2021; Tonetti et al, 2018; Nahas et al, 2019; Cairo et al, 2020; Mathias‐Santamaria et al, 2021), and two studies compared two surgical RC techniques (CAF + CTG vs. tunnel + CTG; and CAF with split‐full‐split thickness vs. CAF with partial thickness) (Santamaria et al, 2017; Clementini et al, 2018).…”

“…A risk‐of‐bias graph is presented in Figure S1. A low risk of bias was determined for 11 studies (McGuire & Nunn, 2003; Cortellini et al, 2009; Cairo et al, 2012, 2020; Fernandes‐Dias et al, 2015; Santamaria et al, 2017, 2021; Clementini et al, 2018; Tonetti et al, 2018; Nahas et al, 2019; Mathias‐Santamaria et al, 2021). Some concerns of bias were found for two studies (Santamaria et al, 2016, 2018).…”

“…Thus, a total of 13 studies were included in this systematic review and metaanalysis. (Cortellini et al, 2009;Cairo et al, 2012Cairo et al, , 2020Fernandes-Dias et al, 2015;Santamaria et al, 2016Santamaria et al, , 2017Santamaria et al, , 2018Santamaria et al, , 2021Clementini et al, 2018;Tonetti et al, 2018;Mathias-Santamaria et al, 2021).…”