Alterations in Location of the Mucogingival Junction 5 Years After Coronally Repositioned Flap Surgery

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Abstract
The aim of this clinical study was to evaluate whether the mucogingival junction (MGJ) reverts back towards its original location following coronally repositioned flap (CRF) procedure over a 5-year follow-up period. Thirteen systemically healthy patients with 26 Miller Class I buccal gingival recessions were treated using the CRF technique. At baseline, and 1, 6, 12, and 60 months after surgery, location of gingival margin (LGM), probing depth (PD), clinical attachment level (CAL), width of keratinized gingiua (WKG), and location of mucogingival junction (LMGJ) were recorded. The alterations in the clinical measurements at the different evaluation times were analyzed using the Friedman and the repeated measure analysis of variance (ANOVA) tests, where applicable. Degree of association between continuous variables was calculated by the Pearson's correlation coefficient. The mean percentage of root coverage obtained at the end of 1 month was 68.26% +/- 30.37% (P<0.05) and at 60 months, it was reduced to 44.86% +/- 33.91% (P<0.01). LGM (r=0.592, P<0.001), CAL (r=0.590, P<0.01), WKG (r=0.442, P<0.05), and LMGJ (r=0.653, P<0.001) were found to be significantly correlated with the 60-month postoperative values of LMGJ. At the end of the 60-month follow-up period, the mean apical displacement of LGM was 0.67 +/- 0.72 mm and the same mean apical displacement value for LMGJ was 0.98 +/- 1.19 mm. Within the limits of this study, the 60-month follow-up findings indicated that the CRF procedure failed to maintain the gingival tissue in a coronal position and that the observed movement of the MGJ back to its original position was partially dependent on the apical movement of gingival margin.