Efficacy of subepithelial connective tissue grafts in the treatment of Miller's Class I and II gingival recessions

The aim of this literature review was to evaluate the efficacy of subepithelial connective tissue grafts (SCTG) in comparison with other commonly used techniques for the coverage of denuded root surfaces. An electronic search was carried out in Medline and Pubmed for randomized controlled clinical trials with at least 6-month follow-ups comparing SCTG with other techniques for the treatment of gingival recession from 1994 up to August 2010. The studies eligible to be included in this review had the following criteria: (a) Miller’s Class I or Class II recession with a depth of at least 2 mm; (b) recession areas containing teeth with no caries or restorations; and (c) at least 10 participants per group at final examination. Of all the studies evaluated, 36 studies were considered relevant. The results showed that decreases in recession depth subsequent to SCTG were significantly greater compared to those with acellular dermal matrix grafts and guided tissue regeneration. Regarding clinical attachment level changes, differences between the groups were not significant. In relation to changes in the keratinized tissue (KT), the results showed a significantly higher gain in the width of KT with SCTG compared to GTR. The results of this review showed that subepithelial connective tissue grafts provide significantly better root coverage, higher clinical attachment gain and greater keratinized tissue width.