An explorative study to develop a predictive model based on avascular exposed root surface area for root coverage after a laterally positioned flap.

Background: The aim of this study is to evaluate the reliability of the avascular exposed root surface area (AERSA) as a prognostic test for gingival recessions (GRs) and to compare the predictive value of the avascular root surface area calculation and Miller classification on the final root-coverage outcomes.

Methods: Ninety-one patients with 91 isolated single GRs (32 Miller Class I, 29 Miller Class II, and 30 Miller Class III defects) located at the upper and lower incisors and canines were treated with a laterally positioned flap. Clinical parameters were recorded and correlated with the achievement of complete root coverage (CRC) after 6 months.

Results: From all clinical parameters used, AERSA showed the highest sensitivity and specificity for predicting CRC. Receiver operating characteristic curves analyses revealed three acceptable cutoff points based on baseline AERSA for achieving CRC with higher sensitivity and specificity values compared to GR depth, GR width, and gingival thickness. Both univariate and multiple linear regression analyses reported that the models could explain the 86% of the mean root coverage with AERSA.

Conclusions: This prospective longitudinal study indicates that AERSA may be used to classify GR defects. The newly developed prognostic model may be used to predict the final root coverage outcomes.