After flap incision and dissection, tetracycline hy-drochloride (HCl) solution (125 mg/ml) was appliedfor 3 minutes with cotton pellets on the recessions.The conditioned root surfaces were rinsed with salinesolution for 45 seconds. After saline irrigation, anSCTG was obtained from the palate, between the dis-tal aspect of the canine and the mid-palatal region ofthe second molar, positioned over the exposed rootsandadjacent tissuebedat theleveloftheCEJ, andsu-tured by 5-0 bioabsorbable sutures. After this, the flapwas coronally advanced at the level of the CEJ andsutured by 5-0 nylon sutures. In all cases, the SCTGwas covered as much as possible by the CAF. Sub-sequently, a non-eugenol periodontal dressing wasplaced over the surgical sites. The dressing and su-tureswereremovedafter8days.Allpatientswerepre-scribed 0.12% chlorhexidine gluconate and instructedto rinse gently twice a day for 3 weeks. During this pe-riod, they were instructed not to brush teeth in treatedareas. Analgesics were prescribed if needed, and allpatients were seen every week for 4 weeks and thenonce a month for 4 months. No adverse effects wereobserved in the donor or recipient sites. At 6 monthspost-surgery, all clinical measurements were re-peated. All surgeries were performed by the sameinvestigator (Figs. 1 through 10).Statistical AnalysisStatistical analysis of the clinical parameters wascarried out to compare the baseline values with the6-month postoperative values using the pairedttestfor all patients, for the group of patients with mandib-ular recessions, and for the group of patients withmaxillary recessions. Intergroup comparisons werealso calculated using the pairedttest. A significancelevel for rejection of the null hypotheses was set ata=0.01. The analyses were performed using a softwarepackage.§The percentage of root coverage was calculatedas follows: ([initial RD-final RD]/initial RD)·100.RESULTSChanges in sulcus depth, percentage of root cover-age, and gain in keratinized gingiva were observedover the course of a 6-month period. The mean RDdecreased from 3.84–1.50 mm at baseline to 0.14–0.23 mm at 6 months (Table 3). In 20 (71%) ofthe 28 sites of multiple gingival recessions, the gingi-val margin was located at the CEJ or coronal to it,whereas in eight sites, the residual recession was<1.0 mm. At the final examination, mean root cover-age was 96%.CALandPDdecreasedfrom5.29–1.30mm(CAL)and 1.52–0.47 mm (PD) at baseline to 1.52–0.47mm (CAL) and 1.12–0.43 mm (PD) at 6 monthspost-surgery. The mean width of KT increased from1.66–1.09 mm at baseline to 3.82–0.91 mm at 6months post-surgery (Table 3). Statistically signifi-cant improvements were found for gingival recession,attachmentlevel,PD, andwidthofKTfrombaselineto6 months (P<0.000) (Table 3).For patients with mandibular MRTDs, mean RD de-creased from 3.64–1.13 mm to 0.21–0.25 mm, PDdecreased from 1.60–0.65 mm to 1.04–0.30 mm,Table 2.
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