1.long-term Stability Of Root Coverage Procedures For Single Gingival Recessions:meta-analysis 2.Case Report Of Tunnel Technique Plus Connective Tissue Graft For Gingival Recession

Background: Various root coverage procedures have been used in treating gingival recession.However,the long-term stability(? 2 years)of different root coverage procedures still remains unclear.Hence,the present study aims to evaluate the long-term stability of root coverage procedures for single gingival recessions.Methods: A complete literature search was performed up to January 2020.Randomized controlled trials(RCTs)following ? 2 years were selected.Primary outcomes were complete root coverage(CRC)and mean root coverage(MRC).Secondary outcomes were width of keratinized tissue(KTW)and patient-centered parameters.Meta-analysis was conducted when possible.Results: A total of 16 RCTs were included in this systematic review and meta-analysis.The results revealed significantly higher MRC in short-term than long-term after coronally advanced flap(CAF;p = 0.006;MD: 7.29%;95% CI: 2.14%-12.44%).When connective tissue graft(CTG)was combined with CAF,no significant difference was shown in MRC for short-term versus long-term(p = 0.21;MD: 1.68mm;95% CI:-0.92 to 4.28mm),and it resulted in greater long-term efficacy than CAF alone in terms of CRC(p = 0.0006;RR: 0.69;95% CI: 0.56-0.85)and KTW(p = 0.04;MD:-0.63 mm;95% CI:-1.21 to-0.04mm).For CAF combined with enamel matrix derivative,the meta-analysis demonstrated no significant difference between the short-term and long-term results of CRC(p = 0.21;RR: 1.26;95% CI: 0.87-1.83).Conclusion: CAF alone could result in decreased postoperative percentage of root coverage with time.However,CAF+CTG could maintain long-term stability and result in better root coverage outcomes than CAF.Background: Various root coverage procedures have been proposed to treat gingival recession,amont which tunnel technique(TUN)combined with connective tissue graft(CTG)is a promising approach to achieve root coverage.This study aims to evaluate the clinical effectiveness of TUN+CTG in treating gingival recession.Methods: Five cases were included in this study with clinical diagnosis of Miller calss I or II recession.After treated by TUN+CTG,clinical parameters were detected including gingival recession depth,mean root coverage(MRC),width of keratinized tissue(KTW)and red esthetic score(RES).Results: Among the 5 patients with 3 gingival recession sites included in this study,the initial mean gingival recession was 2.54±1.76 mm.After TUN+CTG,the mean gingival recession decreased to 0.38±1.12 mm.The result of complete root coverage was 11/13,mean MRC was 93.6±16.0% and mean RES was 8.23±2.20?All patients were satisfied with the outcome.Conclusion: TUN+CTG could achieve favorable root coverage efficacy and esthetic results in treating gingival recession.