Microsurgery for root coverage: A systematic review

OBJECTIVE: To evaluate whether microsurgery gains better result in root coverage compared to conventional surgical techniques. METHODS: A number of databases were searched to identify eligible studies from January 1992 to January 2015. THE FOLLOWING OUTCOMES WERE EVALUATED: number of sites exhibiting complete root coverage and patients’ esthetic satisfaction. RESULTS: Four Randomized Clinical Trials (RCTs) fulfilled the inclusion criteria. A pooled estimate from the two RCTs regarding sub-epithelial connective tissue grafts (SCTG) showed significant achievement in complete root coverage in the microsurgical group [relative risk (RR):1.63; 95% confidence interval (CI): 1.12 to 2.36; P=0.01] with acceptable heterogeneity. The other two studies were about coronal advanced flap (CAF) with enamel matrix derivative or free rotated papilla autograft and did not qualify for meta-analysis. Patients’ esthetic satisfaction was analyzed only by one study. CONCLUSIONS: Using microsurgical technique for treating gingival recessions may be effective in achieving complete root coverage for SCTG.