Procedimentos de recobrimento radicular no tratamento das retrações gengivais: Revisão Cochrane e meta-análise / Root coverage procedures for the treatment of recession-type defects. A Cochrane Systematic Review

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

The objective of this systematic review was to evaluate the effectiveness of different root coverage procedures in the treatment of localized or multiple recession-type defects. Only randomised controlled clinical trials (RCTs) of at least 6 monthsduration were included if the participants met the following criteria: 1) a clinical diagnosis of localized or multiple recession-type defects; 2) recession areas selected for treatment classified as Miller (MILLER 1985) Class I or Class II; 3) recession areas containing teeth with no caries or restorations; and 4) at least 10 participants per group at final examination. In these trials we evaluated the aesthetic condition change related to patients opinion, gingival recession change, clinical attachment change, keratinized tissue change, percentage of sites with complete root coverage and mean root coverage. We searched the Cochrane Oral Health Groups Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. Handsearching included several dental journals. Grey literature included SIGLE search. Quality assessment of the included RCTs was carried out in duplicate and the authors were contacted for missing information. Selection criteria and evaluation followed the Cochrane Oral Health Groups statistical guidelines. Twenty one RCTs were identified between 89 in potential. From them, 12 were included in meta-analysis. One of them showed a statistically significant reduction in gingival recession for subepithelial connective tissue grafts (SCTG) in comparison to guided tissue regeneration (0,39 mm [95% CI: -0,65, -0,12]. Statistically significant changes were also observed related to clinical attachment level (0,62 mm acelluar dermal matrix allograft versus coronally advanced flap [95% CI: 0,09, 1,140]) and for keratinized tissue in three comparisons. Overall, All PPS procedures produced statistically significant improvements in gingival recession, clinical attachment level and keratinized tissue. Mean root coverage and sites with complete root coverage were 80.94% and 46.63%, respectively. In conclusion, all PPS produced statistically significant improvements in all outcomes. However, the SCTG presented the best overall results. In addition, more research is needed to compare different PPS to SCTG (as a control group) in order to evaluate clinical and aesthetic changes. Future RCTs should follow CONSORT guidelines.

ASSUNTO(S)

gingiva/transplantation meta-analysis gingiva/surgery meta-análise gengiva/cirurgia literatura de revisão retração gengival/cirurgia gengiva/enxertos gingival recession/surgery review literature

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