Influência das lesões cervicais não cariosas no tratamento cirúrgico das recessões gengivais

: revisão sistemática

Abstract

Introduction: Gingival recessions are frequently associated with non-carious cervical lesions (NCCLs). There is debate about whether an NCCL should be restored before or during root coverage surgery, as well as about the role of a connective tissue graft in these cases. The aim of this systematic review was to evaluate the efficacy of periodontal plastic surgery for the root coverage of Miller Class I and II or Cairo RT1 gingival recessions, with or without NCCLs, after 6 months, considering the presence or absence of an adhesive restoration and the use of a connective tissue graft. Materials and Methods: This study was conducted as a systematic review following PRISMA guidelines. A literature search was conducted in the PubMed/MEDLINE®, ScienceDirect®, and Scopus® databases through December 2024. Study selection was performed by two independent researchers according to predefined inclusion and exclusion criteria. The quality of the studies was assessed using the Critical Appraisal Skills Programme (CASP) checklist for randomized controlled trials, and agreement between researchers was determined using Cohen’s Kappa coefficient. Results: Ten studies were included. The presence of an NCCL did not compromise the success of root coverage after 6–12 months of follow-up, with no significant differences in the degree of root coverage between cases with and without an adhesive restoration. The use of a connective tissue graft led to a gain in keratinized tissue and benefited recessions with a thin biotype, making root coverage more predictable. Restoring the NCCL does not increase the rate of complete root coverage, but the combined approach (surgery + restoration) resulted in reduced dentin hypersensitivity and improved aesthetics. Conclusion: Gingival recessions with NCCLs can be successfully treated with periodontal plastic surgery without compromising root coverage outcomes. Restoration of the NCCL is not essential for successful root coverage, but should be evaluated on a case-by-case basis for its potential to reduce hypersensitivity and improve aesthetics. The use of a connective tissue graft is recommended in cases with a thin biotype to achieve greater tissue thickness and stability.

Date of Award	23 Jul 2025
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Helena Salgado (Supervisor) & Filipe Miguel Araújo (Co-Supervisor)