Coronally advanced flap versus the pouch technique combined with a connective tissuegraft to treat Miller's class I gingival recession: a randomized controlled trial

Aim The objective of this study was to compare two different periodontal plastic surgery procedures to treat Miller's class I recession: a coronally advanced flap (control group) versus the pouch technique (test group), both of which were associated with connective tissue graft. Methods Forty consecutive patients were included, with 20 patients being allocated for each group. The level of recession coverage, the keratinized tissue (KT) quantity, gingival aesthetics (PES) and post-operative outcomes were assessed for a follow-up period of 6months. Results After 6months, both techniques allowed for the excellent mean root coverage of 96.3 +/- 12.1% in the control group and of 91.3 +/- 17.6% in the test group. Complete root coverage was achieved in 89.5% (17/19) and 79% (15/19) of the recession cases in the control and the test groups respectively. A significant increase in KT height (p=0.0011) was observed in the test group. A significant improvement in the pink aesthetic score was found in the two groups, but gingival texture displayed significantly better results in the test group (p<0.0001). No significant difference between the two groups was found in terms of the morbidity outcomes. Pain killer consumption was similar in the two groups and significantly decreased over time. Conclusions Both surgical techniques are relevant in treating Miller's class I recession. The pouch technique seems to increase the height of KT better and provides good gingival-related aesthetic outcomes.