Assessment of the effect of orthodontic treatment on the stability of pre-orthodontic recession coverage by connective tissue graft: a randomized controlled clinical trial

Objective:To compare the changes in periodontal parameters after orthodontic treatment in patients having isolated gingival recession treated with and without pre-orthodontic gingival recession coverage. Method and materials: Thirty-six patients requiring orthodontic treatment with a facially positioned mandibular anterior tooth with labial recession were randomly allocated to either test group: root coverage by subepithelial connective tissue graft (SCTG) followed by orthodontic treatment, or control group (orthodontic treatment only). Primary clinical parameters included recession depth, keratinized tissue width, root coverage, root esthetic score, and gingival phenotype. The patients were followed up for at least 1 year. Results: Level of gingival margin attained in test group teeth after SCTG were maintained at end of orthodontic treatment (P = .727). Root coverage achieved was 69.33 +/- 30.74% versus 22.36 +/- 27.70% in test and control group, respectively (P = .000), and gain in keratinized tissue width was 1.59 +/- 0.73 mm in test versus 0.41 +/- 0.49 mm in control group (P = .000). The number of teeth with improved gingival phenotype and decreased hypersensitivity was also observed to be statistically significant in the test group (P = .049, P = .002). Conclusion: Root coverage procedure may be performed before the planned orthodontic treatment as graft stability is preserved throughout the course of orthodontic treatment.