Efficacy of De-Epithelialized vs. Subepithelial Grafts in Periodontal Plastic Surgery for Gingival Recession: A Systematic Review and Meta-Analysis of Root Coverage Techniques.
Lucrezia Parma Benfenati, Saeed Abdelaziz ElRefaei, Muhammad H A Saleh et al.
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In 30 seconds
This systematic review and meta-analysis compared de-epithelialized gingival grafts (DGG) with subepithelial connective tissue grafts (SCTG) for RT1 gingival recessions. It included six randomized clinical trials involving 221 patients. Mean recession coverage did not differ significantly between techniques (MD = -0.51 mm; 95% CI: -2.06 to 1.03; p = 0.368). Complete root coverage favored DGG (MD = 4.45%; 95% CI: 1.21-7.69; p = 0.027), while esthetic scores and patient-reported outcomes showed no consistent differences.
Key findings
- Mean recession coverage showed no significant difference between DGG and SCTG (MD = -0.51 mm; 95% CI: -2.06 to 1.03; p = 0.368; I 2 = 95.9%).
- Complete root coverage favored DGG (MD = 4.45%; 95% CI: 1.21-7.69; p = 0.027; I 2 = 0%).
- Small differences in keratinized tissue width gain and probing depth reduction favored DGG; heterogeneity was substantial for probing depth change.
- Esthetic scores and patient-reported pain or discomfort showed no consistent differences.
Why it matters
Both grafting approaches were effective for RT1 recession, and the pooled findings suggest DGG may modestly improve the likelihood of complete root coverage without a consistent disadvantage in esthetics or patient comfort. The absence of a significant difference in mean coverage and the variability in some outcomes are important when interpreting the apparent advantage.
What to keep in mind
The evidence comprised six trials and showed substantial heterogeneity for mean recession coverage and probing depth change, limiting certainty about comparative effects.