Guided tissue regeneration versus mucogingival surgery in the treatment of human buccal recessions. A 4-year follow-up study.

The 4-year follow-up results of a clinical trial are reported. The clinical results of the treatment of buccal recession were analyzed comparing the outcomes of a guided tissue regeneration (GTR) procedure with nonresorbable membranes and a 2-step mucogingival procedure consisting of a coronally-positioned free gingival graft in two groups of 25 patients each. The final root coverage was 73.07% in the test group (GTR) and 72.3% in the control group (mucogingival surgery). In the test group, statistically significant recession reduction, probing depth reduction, clinical attachment level gain, and increase of keratinized tissue width were observed. In the control group the results were similar except for probing depth, which did not vary significantly. At the end of the 4-year follow-up period, the average periodontal conditions did not differ between the 2 groups, with the exception of the keratinized tissue width. This was obviously greater in the control group, where a free gingival graft had been carried out. Recessions > or = 5 mm had a greater root coverage after GTR treatment. In both groups, the periodontal parameters remained stable between 18 months and 4 years after surgery, indicating remarkable stability; the only exception was a significant increase in the keratinized tissue width in the test group. When the changes between the baseline and the 4-year follow-up were compared, the average reduction in the recession was similar in the two groups while probing depth reduction and clinical attachment level were greater in the GTR group.