The Use of a Connective Tissue Graft Wall as an Adjunct to Regenerative Treatment for Deep Intrabony Defects Associated with Gingival Recession: A Retrospective Case Series with a 5-Year Follow-up.

The adjunctive use of connective tissue grafts (CTGs) in the periodontal regeneration of intrabony defects has been proposed to prevent or limit postoperative gingival recession. However, there is limited evidence regarding the long-term clinical performance of this approach. This article presents the 5-year follow-up outcomes of a combination therapy using CTGs, bone substitutes, and biologic materials for the treatment of deep intrabony defects associated with gingival recession. Twelve healthy, nonsmoking patients with 12 deep intrabony defects participated in the study. Before undergoing the described treatment regimen, these patients had a baseline (immediately preoperative) mean clinical attachment loss of 9.9 ± 2.1 mm, a mean probing depth (PPD) of 7.8 ± 1.5 mm, and a mean buccal recession (REC) of 2.3 ± 1.8 mm. After 5 years, the mean clinical attachment level (CAL) gain was 5.7 ± 3.2 mm (P < .001), the mean reduction in PPD was 5.1 ± 1.6 mm (P < .001), and the mean reduction in REC was 1.2 ± 2.1 mm (P = .07). Of the sites, 91% achieved CAL gain ≥ 3 mm and PPD ≤ 4 mm. Compared to baseline, 7 out of 12 sites showed an REC reduction ≥ 1 mm, while 3 sites remained stable, and 2 sites experienced an increase in gingival recession depth (1 and 2 mm, respectively). Within the limitations of this case series, periodontal regenerative therapy incorporating the adjunctive use of a CTG was shown to be effective for treating deep noncontained periodontal intrabony defects and subsequently stabilizing or slightly improving the gingival margin over 5 years.