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Article: Aesthetic‐And patient‐related outcomes following root coverage procedures: A systematic review and network meta‐analysis

TitleAesthetic‐And patient‐related outcomes following root coverage procedures: A systematic review and network meta‐analysis
Authors
Keywordsaesthetics
gingival recession
meta‐analysis
connective tissue graft
coronally advanced flap
Issue Date2020
PublisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1600-051X
Citation
Journal of Clinical Periodontology, 2020, v. 47 n. 11, p. 1403-1415 How to Cite?
AbstractBackground: Aim of this systematic review (SR) of randomized controlled trials (RCTs) was to evaluate effect of different flap designs and graft materials for root coverage, in terms of aesthetics, patient satisfaction and self‐reported morbidity (post‐operative pain/discomfort). Material and Methods: A comprehensive literature search was performed. A mixed‐modelling approach to network meta‐analysis was utilized to formulate direct and indirect comparisons among treatments for Root Coverage Esthetic Score (RES), with its individual components, and for subjective patient‐reported satisfaction and post‐operative pain/discomfort (visual analogue scale (VAS) of 100). Results: Twenty‐six RCTs with a total of 867 treated patients (1708 recessions) were included. Coronally Advanced Flap (CAF) + Connective Tissue Graft (CTG) (0.74 (95% CI [0.24, 1.26], p = .005)), Tunnel (TUN) + CTG (0.84 (95% CI [0.15, 1.53]), p = .01) and CAF + Graft substitutes (GS) (0.55 (95% CI [0.006, 1.094], p = .04)) were significantly associated with higher RES than CAF. No significant difference between CAF + CTG and TUN + CTG was detected (0.09 (95% CI [−0.54, 0.72], p = .77)). Addition of CTG resulted in less natural tissue texture (−0.21 (95% CI [−0.34, −0.08]), p = .003) and gingival colour (−0.06 (95% CI [−0.12, −0.03], p = .03)) than CAF. CTG techniques were associated with increased morbidity. Conclusions: Connective tissue graft procedures showed highest overall aesthetic performance for root coverage, although graft integration might impair soft tissue colour and appearance. Additionally, CTG‐based techniques were also correlated with a greater patient satisfaction and morbidity.
Persistent Identifierhttp://hdl.handle.net/10722/294580
ISSN
2021 Impact Factor: 7.478
2020 SCImago Journal Rankings: 3.456
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorCairo, F-
dc.contributor.authorBarootchi, S-
dc.contributor.authorTravelli, L-
dc.contributor.authorBarbato, L-
dc.contributor.authorWang, HL-
dc.contributor.authorRasperini, G-
dc.contributor.authorGraziani, F-
dc.contributor.authorTonetti, M-
dc.date.accessioned2020-12-08T07:38:59Z-
dc.date.available2020-12-08T07:38:59Z-
dc.date.issued2020-
dc.identifier.citationJournal of Clinical Periodontology, 2020, v. 47 n. 11, p. 1403-1415-
dc.identifier.issn0303-6979-
dc.identifier.urihttp://hdl.handle.net/10722/294580-
dc.description.abstractBackground: Aim of this systematic review (SR) of randomized controlled trials (RCTs) was to evaluate effect of different flap designs and graft materials for root coverage, in terms of aesthetics, patient satisfaction and self‐reported morbidity (post‐operative pain/discomfort). Material and Methods: A comprehensive literature search was performed. A mixed‐modelling approach to network meta‐analysis was utilized to formulate direct and indirect comparisons among treatments for Root Coverage Esthetic Score (RES), with its individual components, and for subjective patient‐reported satisfaction and post‐operative pain/discomfort (visual analogue scale (VAS) of 100). Results: Twenty‐six RCTs with a total of 867 treated patients (1708 recessions) were included. Coronally Advanced Flap (CAF) + Connective Tissue Graft (CTG) (0.74 (95% CI [0.24, 1.26], p = .005)), Tunnel (TUN) + CTG (0.84 (95% CI [0.15, 1.53]), p = .01) and CAF + Graft substitutes (GS) (0.55 (95% CI [0.006, 1.094], p = .04)) were significantly associated with higher RES than CAF. No significant difference between CAF + CTG and TUN + CTG was detected (0.09 (95% CI [−0.54, 0.72], p = .77)). Addition of CTG resulted in less natural tissue texture (−0.21 (95% CI [−0.34, −0.08]), p = .003) and gingival colour (−0.06 (95% CI [−0.12, −0.03], p = .03)) than CAF. CTG techniques were associated with increased morbidity. Conclusions: Connective tissue graft procedures showed highest overall aesthetic performance for root coverage, although graft integration might impair soft tissue colour and appearance. Additionally, CTG‐based techniques were also correlated with a greater patient satisfaction and morbidity.-
dc.languageeng-
dc.publisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1600-051X-
dc.relation.ispartofJournal of Clinical Periodontology-
dc.rightsSubmitted (preprint) Version This is the pre-peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Accepted (peer-reviewed) Version This is the peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.-
dc.subjectaesthetics-
dc.subjectgingival recession-
dc.subjectmeta‐analysis-
dc.subjectconnective tissue graft-
dc.subjectcoronally advanced flap-
dc.titleAesthetic‐And patient‐related outcomes following root coverage procedures: A systematic review and network meta‐analysis-
dc.typeArticle-
dc.identifier.emailTonetti, M: tonetti@hku.hk-
dc.identifier.authorityTonetti, M=rp02178-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/jcpe.13346-
dc.identifier.pmid32654220-
dc.identifier.scopuseid_2-s2.0-85089100598-
dc.identifier.hkuros320328-
dc.identifier.volume47-
dc.identifier.issue11-
dc.identifier.spage1403-
dc.identifier.epage1415-
dc.identifier.isiWOS:000567409600001-
dc.publisher.placeUnited States-

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