Prognostic Factors: Defect Related Factors
Recession classification is a crucial parameter in studies assessing root coverage procedures . Miller  has described four classes according to the prognosis of root coverage. The height of the interproximal soft and hard tissues is an important prognostic factor for root coverage. In Class I and II gingival recessions, Miller  suggested the possibility of complete root coverage (CRC) with the free gingival graft approach. Only partial root coverage could be predicted in Class III. However, root coverage is not possible in Class IV. Recently, Cairo et al.  introduced a new classification based on the amount of the interproximal clinical attachment loss (CAL). The interdental CAL could be considered as a viable parameter to evaluate the interproximal hard tissue resorption. This clinical tool is an important predictor of the clinical outcomes of the different root coverage surgical techniques used. It should be hypothesized that root coverage after surgery could not exceed the coronal level of interproximal CAL. For many years, it has been accepted that CRC couldn’t be achieved in gingival recessions associated with interdental hard tissue resorption (Miller Cl III and IV) . However, recent studies [4, 5] demonstrated that CRC might be predictable also in Class III Miller gingival recessions. Hence, it was demonstrated by Cairo et al.  that CRC could be achieved in type 2 gingival recessions (GRT2). CRC could be obtained when interproximal CAL value is ≤3 mm. However, de Sanctis and Clementini  suggested in their meta-analysis that available data to support these findings are lacking.
- 4.Cairo F, Cortellini P, Tonetti M, Nieri M, Mervelt J, Cincinelli S, et al. Coronally advanced flap with and without connective tissue graft for the treatment of single maxillary gingival recession with loss of inter-dental attachment. A randomized controlled clinical trial. J Clin Periodontol. 2012;39:760–8.CrossRefPubMedGoogle Scholar
- 8.Cortellini P, Tonetti M, Baldi C, Francetti L, Rasperini G, Rotundo R, et al. Does placement of a connective tissue graft improve the outcomes of coronally advanced flap for coverage of single gingival recessions in upper anterior teeth? A multi-centre, randomized, double blind, clinical trial. J Clin Periodontol. 2009;36:68–79.CrossRefPubMedGoogle Scholar
- 9.Clauser C, Nieri M, Franceschi D, Pagliaro U, Pini Prato GP. Evidence-based mucogingival therapy. Part 2: ordinary and individual patient data meta-analyses of surgical treatment of recession using complete root coverage as the outcome variable. J Periodontol. 2003;74:741–56.CrossRefPubMedGoogle Scholar