Root Coverage Employing an Envelope Technique or Guided Tissue Regeneration With a Bioabsorbable Membrane

Abstract
Background: Different treatment modalities have been described for root coverage in cases of gingival recession. The aim of the present study was to evaluate the postsurgical outcome of 2 modes of surgical root coverage of predominantly shallow, Class I or II, gingival recessions.Methods: Fourteen buccal recession sites in 13 patients were treated with free connective tissue grafts employing a modified envelope technique; 14 sites in 9 patients were subjected to a coronally repositioned flap in combination with a bioabsorbable membrane. Immediately before surgery as well as after 6 months, gingival dimensions, i.e., width and thickness, as well as root coverage and attachment gain, were assessed to the next 0.1 mm employing a caliper, an ultrasonic device, and a pressure calibrated, computerized periodontal probe.Results: At the outset, mean recession depths amounted to 2.48 ± 1.06 and 3.00 ± 1.95 mm for patients treated with a free connective tissue graft and a bioabsorbable membrane, respectively. With the former technique, 80 ± 24% root surface could be covered after 6 months, while the latter resulted in only 45 ± 40% coverage. The contrast in reduction of recession width was even more pronounced (77 ± 35% versus 18 ± 37%). In both groups, an increase of gingival thickness of 0.6 to 0.7 mm was noticed.Conclusions: Small recessions may be covered more predictably with the modified envelope technique. J Periodontol 1999;70:743‐751.

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