The influence of local anatomy on the outcome of treatment of gingival recession associated with non-carious cervical lesions.

BACKGROUND: The present study evaluates the influence of local anatomy on the reduction in relative gingival recession (Delta RGR) and gain of clinical attachment level (Delta CAL) achieved by coronally advanced flap alone (CAF), CAF plus restoration (CAF + R), subepithelial connective tissue graft alone (CTG), and CTG plus restoration (CTG + R), to treat Miller Class I gingival recessions associated with non-carious cervical lesions.

METHODS: A total of 78 defects in maxillary canines or premolars were included, and received one of the following treatments: CAF, CAF + R, CTG, or CTG + R. Delta RGR and Delta CAL after 6 months were associated with cervical lesion height (CLH), cervical lesion width, cervical lesion depth (CLD), keratinized tissue width, keratinized tissue thickness, papillae width, papillae height, bone level (BL), and post-surgical position of the gingival margin using stepwise multivariate linear regression.

RESULTS: CLH was statistically associated with Delta RGR when CAF (P = 0.02) and CTG + R (P = 0.0002) were analyzed and statistically associated with Delta RGR when overall data (P = 0.005) from both CTG groups were analyzed. CLD was significantly associated with Delta RGR in the CAF group (P = 0.0045). BL was statistically associated with Delta RGR when evaluating the CTG group (P = 0.02). It was also significantly associated with Delta CAL when considering the CTG (P = 0.01) and the overall data (P = 0.04) from CAF (CAF and CAF + R).

CONCLUSIONS: It can be concluded that CLD may influence Delta RGR when CAF is performed to treat combined defects. Additionally, BL may not negatively influence Delta RGR when the CTG technique is used.