Clinical evaluation of single-stage advanced versus rotated flaps in the treatment of gingival recessions.

Background: Several procedures have been reported for the surgical correction of gingival recession (GR), including the laterally positioned flap (LPF) and the coronally advanced flap (CAF), performed as single- or two-stage procedures without or with, respectively, the preceding placement and healing of a free gingival graft. The objective of the present report was to compare the efficacy of single-stage LPF and CAF techniques in the treatment of localized maxillary GR defects.

Methods: Thirty-six patients, 10 men and 26 women, with average age of 34 + or - 9 years with Miller Class I GR defects were randomly assigned to be treated by either a CAF (n = 18) or LPF (n = 18). Clinical parameters, including recession height, the width of keratinized tissue (WKT), probing depth, and vertical clinical attachment level were assessed at the mid-buccal site. Visual plaque score and bleeding on probing were also assessed dichotomously. Clinical recordings were performed at baseline and 6 months later. Intermeasurements differences were analyzed with a chi-square or a Wilcoxon test, with significance set at alpha<0.05.

Results: Both flap designs were effective in treating recession defects resulting in similar improvements for percentage of root coverage, frequency of complete root coverage, and gain in clinical attachment level. The LPF resulted in significantly more gains in WKT than the CAF.

Conclusion: The results obtained by CAF in the treatment of Miller Class I maxillary GR are clinically similar to the LPF albeit with more limited gains in WKT.