Gingival dimensions after root coverage with free connective tissue grafts

Traumatic injury in the presence of a thin and narrow zone of gingival tissue may lead to gingival recession. Especially in class I and II recessions, root coverage may be accomplished with connective tissue grafts. In order to prevent recurrent recession, altering gingival dimensions width and thickness might be of advantage. In the present study, dimensions of gingiva were followed for 1 year after root coverage with connective tissue grafts. The study population consisted of 18 patients with a total of 28 class I or II recessions. Gingival width and depth of the recession were measured with a caliper, and thickness of the marginal tissue with an ultrasonic device. Periodontal probing depth was determined with a pressure-controlled electronic probe. Mean (+/-sd) recession depth at baseline was 3.1+/-1.4 mm. After 12 months, coverage amouted to 74+/-30%. Width of gingiva rose from 2.1+/-1.0 mm to 3.2+/-1.4 mm, whereas thickness was increased from 0.8+/-0.3 mm to 1.5+/-0.7 mm, on average. No significant alteration of periodontal probing depth was observed but a mean gain of clinical attachment of 1.7+/-1.1 mm was ascertained. In a multiple regression analysis, recession depth and presence of the recession in the maxilla, but not tooth type significantly influenced relative root coverage (R-2=0.34, p<0.01). Attachment gain after surgery depended on baseline attachment loss and was negatively influenced by smoking. The present results point to the possibility of doubling gingival thickness after root coverage with connective tissue grafts.