The influence of non-carious lesions in the surgical treatment of gingival recession: A systematic review & meta-analysis.

J Dent

Laboratory of Orofacial Pathologies, Imaging and Biotherapies UR2496, Université de Paris, Montrouge F-92120, France; Service de Médecine Bucco-Dentaire, AP-HP, Hôpital Charles Foix, Ivry/Seine F-94200, France. Electronic address:

Published: February 2022

Background: The presence of a non-carious cervical lesion (NCCL) is a complicating factor for tooth coverage following gingival recession. It is generally associated with disappearance of the enamel-cementum junction, a key landmark, and a surface discrepancy requiring restoration or compensation using a connective tissue graft (CTG). The aim of this systematic review is to study the efficacy of periodontal plastic surgery on recession defects associated with a NCCL, with or without restorative treatment.

Materials And Methods: RCT assessing the root coverage of teeth with Miller's class I and class II isolated gingival recession with an NCCL published up to April 2020, with at least 10 patients per group and a follow-up longer than 6 months, were included through electronic databases and hand-searched journals.

Results: Seven articles were finally included. Treatment systematically consisted of a coronally advanced flap in association with partial or complete restorative treatment ± CTG. Meta-analyses showed that periodontal plastic procedures are less effective in terms of complete root coverage in cases of teeth with an NCCL. Overall Mean Recession Reduction was 2.00 mm (CI: [1.72, 2.28]), and overall mean complete root coverage was 5% (CI: [2,8]).

Conclusion: The presence of an NCCL is a complicating factor in plastic surgery. The use of CTG without NCCL restoration provides better outcomes except for the reduction of dental hypersensitivity for which the combined treatment (restoration + CTG) is the most effective.

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http://dx.doi.org/10.1016/j.jdent.2021.103922DOI Listing

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