Coronally advanced flap and composite restoration of the enamel with or without connective tissue graft for the treatment of single maxillary gingival recession with non-carious cervical lesion. A randomized controlled clinical trial

Background: Aim of this study was to compare coronally advanced flap (CAF) and composite restoration of the cement–enamel junction (CEJ) with or without connective tissue graft (CTG) for treatment of single maxillary gingival recession with non-carious cervical lesion (NCCL). Material and Methods: Thirty patients with single gingival recessions and previously restored NCCL were randomly allocated to the two groups. A masked examiner evaluated recession reduction (RecRed), complete root coverage (CRC), keratinized tissue (KT) gain, increase in gingival thickness (GT), patient satisfaction and Root coverage Esthetic Score (RES). Results: No significant difference for RecRed and CRC was detected at 12 months. CAF + CTG resulted in greater increase of KT width and thickness (p <.001). An interaction between baseline GT and type of treatment was reported, suggesting that when baseline GT was ≤0.84 mm adding CTG led to higher RecRed, while for values >0.84 mm the use of CAF was associated with better outcomes. Similarly, CAF alone provided better final RES score for baseline GT > 0.82 mm. Conclusion: Both procedures were effective for root coverage at single RT1 recession with previously restored CEJ. Adding a CTG under CAF should be considered for Rec with thin gingival phenotype.