Success in Gingival Recession Coverage: Prognostic Indicators From Private Practice

Purpose: To identify parameters associated with successful root coverage, defined as 70% and 50% root coverage in Miller Class I–II/RT1 and III/RT2 defects, respectively, within periodontal office settings. Methods: Dental records of patients treated for gingival recessions were screened retrospectively. General health parameters, smoking status, pre and posttreatment recession depth (RD), that is, RD and residual RD (RRD), respectively, recession width (RW), keratinized tissue (KT) width, and clinical attachment loss (CAL) were extracted. Logistic regression linear mixed-effects models were used to identify correlations between patient- and treatment-specific variables and the success of gingival recession defect coverage up to 180 months. Results: Records from 105 surgically treated recessions (82 Miller Class-I–II/RT1, 23 Miller Class-III/RT2) in 56 patients (46 females, 10 males) were retrieved. Mean follow-up was 3.52 (1–15) years post-surgery. Smoking, Miller Class II/RT1 and III/RT2, and lateral teeth were negatively associated with treatment success (effect sizes: smoking −21.0, Miller II/RT1 −21.5, Miller III/RT2 −21.4, lateral −21.1; all p < 0.001), whereas canines and first premolars were positively associated with successful coverage (effect sizes: canine 1.71, first premolar 10.31; all p < 0.001). Univariate linear regression revealed that initial RD, RW, and Miller Class III/RT2 were significantly associated with higher CAL gain (estimates: RD 0.71, RW 0.65, Miller III/RT2 1.14), higher KT gain (estimates: RD 0.34, RW 0.33, Miller III/RT2 0.99), and lower RRD (estimates: Miller II/RT1 0.72, Miller III/RT2 0.92, RD 0.28, RW 0.30) (all p < 0.05). Conclusions: Long-term root coverage is negatively correlated with smoking, Miller Class II–III/RT1–2 recessions, and lateral teeth but positively related to canines and first premolars. CAL/KT gain and RRD are positively influenced by initial RD, RW, and Miller Class-III/RT2.