Subepithelial Connective Tissue Graft for Root Coverage in Smokers and Non‐Smokers: A Clinical and Histologic Controlled Study in Humans

Abstract

Root coverage with subepithelial connective tissue graft was negatively affected by smoking, which limited and jeopardized treatment results.

Treatment of gingival recessions in heavy smokers using two surgical techniques: a controlled clinical trial

“…These data are alarming for the daily practice because smokers might not be entirely satisfied with the aesthetic improvement through a small reduction in gingival recession and such a low predictability for full root coverage procedure. The damage caused by smoking seems to have been intense enough to make the majority of smoking patients of the present study yield a root coverage of less than 50% (67.5% of the cases), while for Souza et al (15) the majority of smokers presented root coverage between 50% and 99% (60% of the cases).…”

“…After 6 months, this had occurred in only 2 cases (5% of the treated cases -data not show), both in TG, without statistically significant difference from CG. Souza et al (15) reported full root coverage in 6.7% of the cases, while Erley et al (14) obtained 25% and Andia et al (11) obtained none. These data are alarming for the daily practice because smokers might not be entirely satisfied with the aesthetic improvement through a small reduction in gingival recession and such a low predictability for full root coverage procedure.…”

“…Two sections from each region (palate and marginal gingiva) were stained using hematoxylin and eosin (HE) and another two were stained with Masson's Trichrome for each one of the studied groups. The methodology described by Souza et al (15) was followed for the histomorphometrical analysis. The histological and histomorphometrical analyses were carried out by a single operator blinded to the study groups.…”

“…However, studies comparing smoking and non-smoking patients under root coverage procedures reported a negative influence of smoking on treatment predictability (3,11,14,15).…”

“…The large number of tobacco toxins may impair periodontal healing (3). Smoking also decreases periodontal blood flow (14,15,17), compromising graft vascularization (14) and subepithelial connective tissue graft (SCTG) outcomes.…”