Coronally advanced flap: a modified surgical approach for isolated recession-type defects: three-year results.

Various modifications of the coronally displaced flap have been proposed in the literature with the attempt of treating gingival recession with uneven predictable results. The goal of the present study was to evaluate the effectiveness with respect to root coverage of a modification of the coronally advanced flap procedure for the treatment of isolated recession-type defects in the upper jaw. Methods: Forty isolated gingival recessions with at least 1 mm of keratinized tissue apical to the defects were treated with a modified approach to the coronally advanced flap. The main change in the surgical procedure consisted in the modification of flap thickness and dimension of surgical papillae during flap elevation. All recessions fall into Miller class I or II. The clinical re-evaluation was performed 1 year and 3 years after the surgery. Results: At the 1-year examination, the average root coverage was 3.72 ± 1.0 mm (98.6% of the pre-operative recession depth) and 3.64 ± 1.1 mm (96.7%) at 3 years. The gain in probing attachment amounted to 3.65 ± 1.10 mm at 1 year and to 3.70 ± 1.09 mm at 3 years. The average increase of keratinized tissue between the baseline and the 3-year follow-up amounted to 1.78 ± 0.90 mm. All changes of keratinized tissue (difference between baseline and 1 year, baseline and 3 years, and between 1 and 3 years) were statistically significant. Conclusion: The modified coronally advanced surgical technique is effective in the treatment of isolated gingival recession in the upper ja