Management of Gingival Recession After Restoration of Non-Carious Cervical Lesions

Restorative and Surgical Protocol

The American Academy of Periodontology recommends performing coronally advanced flap (CAF) with connective tissue graft (CTG) as the gold standard approach for root coverage, achieving approximately 70-92% root coverage while maintaining long-term gingival margin stability 1, 2
The presence of a gingival thickness of at least 1.46mm at 6 months is the main determinant of long-term gingival margin stability, with sites requiring at least 1.5mm of keratinized tissue width to prevent recession recurrence 3, 4, 5

L-PRF membranes (3-4 layers) can be used with CAF as an alternative to CTG, avoiding palatal harvesting 7
rhPDGF-BB with beta-tricalcium phosphate or soft tissue matrices may be considered, though long-term data shows significant reduction in coverage from 89.85% at 6 months to 74.10% at 5 years 2, 3, 5
Autogenous CTG demonstrates superior long-term stability (89.35% coverage at 5 years) compared to growth factor approaches 2, 3

The American Academy of Periodontology recommends restricting to soft food intake with no biting/chewing in treated area for 1 week, and rinsing with 0.12% chlorhexidine twice daily for at least 3 weeks (starting day 3) 7
Relying solely on growth factor approaches without addressing soft tissue thickness leads to significant recession recurrence over 5 years, and proceeding with CAF alone in thin phenotype cases results in long-term recession 2, 3, 5