The purpose of this study is to show that complete root coverage is not only a successful but also a predictable procedure using the free soft tissue autograft on roots that exhibit deep-wide marginal tissue recession.
A sample size of 100 was used in this 4 1/2 year study. Ages 8 to 52. There were 91 mand. and 9 max. Width of recession approached 3 mm, and total recession ranging from 2 to 14 mm. Initially non-citric acid was controlled but they exhibited recession, thus discontinued.
All instrumentation was performed with hand curettes and saturated citric acid was used. Root surface is flatten to decrease the width of recession, and emphasize only in the area of the CEJ, and for intimate contact of the graft. Cotton pledgets were used and the citric acid was burnished for five minute. Area flushed and a template was made. The recipient site is prepared. Horizontal incisions were made in the interdental area at the level of the CEJ. Vertical incision were made at the proximal line angles. The retracted tissue was total excised. The incision formed are butt-joints. Periosteum is left intact. A thick donor tissue from palate, and submucosa is removed by sharp dissection. Sutures are resorbable, and placed at papilla and apical corners. Coe-pak dressing.
Root coverage was considered 100% if the gingival margin was at the cementoenamel junction, and sulcus depth was 2 mm or less, and there was no bleeding on probing. Primary root coverage was obtained in the first 10 weeks. Thereafter is was consisted secondary root coverage or creeping attachment.
As one step procedure complete root coverage is both successful and predictable. A second procedure is not necessary. The width and depth of marginal tissue recession are not over-riding considerations in obtaining root coverage. Patient acceptance of the esthetics was unanimous.
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