Root coverage procedures improve patient aesthetics. A systematic review and Bayesian network meta-analysis

Francesco Cairo*, Umberto Pagliaro, Jacopo Buti, Michela Baccini, Filippo Graziani, Paolo Tonelli, Gabriella Pagavino, Maurizio S. Tonetti

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Background: The aim of this study was to perform a systematic review (SR) of randomized controlled trials (RCTs) to explore if periodontal plastic surgery procedures for the treatment of single and multiple gingival recessions (Rec) may improve aesthetics at patient and professional levels. Material and Methods: In order to combine evidence from direct and indirect comparisons by different trials a Bayesian network meta-analysis (BNM) was planned. A literature search on PubMed, Cochrane libraries, EMBASE, and hand-searched journals until January 2016 was conducted to identify RCTs presenting aesthetic outcomes after root coverage using standardized evaluations at patient and professional level. Results: A total of 16 RCTs were selected in the SR; three RTCs presenting professional aesthetic evaluation with Root coverage Aesthetic Score (RES) and three showing final self-perception using the Visual Analogue Scale (VAS Est) could be included in a BNM model. Coronally Advanced Flap plus Connective Tissue Graft (CAF + CTG) and CAF + Acellular Dermal Matrix (ADM) and Autologous Fibroblasts (AF) were associated with the best RES outcomes (best probability = 24% and 64%, respectively), while CAF + CTG and CAF + CTG + Enamel matrix Derivatives (EMD) obtained highest values of VAS Est score (best probability = 44% and 26%, respectively). Conclusions: Periodontal Plastic Surgery (PPS) techniques applying grafts underneath CAF with or without the adding of EMD are associated with improved aesthetics assessed by final patient perception and RES as professional evaluation system.

Original languageEnglish
Pages (from-to)965-975
Number of pages11
JournalJournal of Clinical Periodontology
Volume43
Issue number11
Early online date16 Sept 2016
DOIs
Publication statusPublished - 1 Nov 2016

Keywords

  • aesthetics
  • gingival recession
  • meta-analysis
  • systematic review

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