{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:10:44Z","timestamp":1789495844600,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,8,10]],"date-time":"2018-08-10T00:00:00Z","timestamp":1533859200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Subepithelial connective tissue graft with coronally advanced flap (SCTG + CAF) has been considered the best and most predictable root coverage procedure. Thus, the aims of this study are two\u2010fold: 1) to evaluate the long\u2010term outcomes following SCTG + CAF in the treatment of gingival recessions (GR) and 2) to explore the influence of several tooth\/patient\u2010related factors on the stability of gingival margin at 1 year and at 5,10, 15, and 20 years after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010five patients with 45 maxillary GR (Miller's Class I or III) were treated with SCTG + CAF in a private practice between 1990 and 1997. Recession depth (RD), probing depth (PD), keratinized tissue (KT) width and patient\/tooth\u2010associated variables were recorded for each GR at baseline, 1, 5, 10, 15, and 20 years after surgery. Parametric, non\u2010parametric, and logistic regression statistics were used throughout the study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 21 Class I (44.67%) and 24 Class III (53.33%) GR were treated. Considering all the 45 GR, statistically significant improvements were found for RD in all evaluations (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.05) compared with baseline data. Over the course of the study, mean root coverage (MRC) decreased from 74.23% (1 year) to 67.69% (20 years). Within maxillary Class I defects, complete root coverage (CRC) at 1\u2010year follow\u2010up was 57.14% (n\u00a0=\u00a012) and 47.62% (n\u00a0=\u00a010) at the end of study period, whereas MRC decreased from 82.37% to 77.62%, respectively. Within maxillary Class III recessions, CRC of 20.83% (n\u00a0=\u00a05) was found at both the 1\u2010year and the 20\u2010year follow\u2010ups. On the other hand, MRC decreased from 66.55% to 58.18%, respectively. The results of logistic regression analysis showed that the achievement of CRC was associated with sites not presenting interdental tissue loss (i.e., Class I, odds ratio: 5.031, <jats:italic>P\u00a0<\/jats:italic>=\u00a00.024), whereas GR recurrence appeared associated with sites with attached KT\u00a0&lt;\u00a02\u00a0mm (i.e., 5\u2010, 10\u2010, 15\u2010 and 20\u2010year follow\u2010ups), to teeth presenting root steps (i.e., 10\u2010 and 20\u2010year follow\u2010ups), and smoking (i.e., 15\u2010year follow\u2010up).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Positive RD reduction and KT improvements achieved by SCTG + CAF at short\u2010term may be preserved long\u2010term with the majority of the treated sites not displaying relapse of the gingival margin. Teeth lacking a minimal 2\u2010mm width of attached KT and presenting non\u2010carious cervical lesions were more prone to develop an apical shift of the gingival margin during a 20\u2010year follow\u2010up period.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jper.17-0619","type":"journal-article","created":{"date-parts":[[2018,6,6]],"date-time":"2018-06-06T03:33:09Z","timestamp":1528255989000},"page":"1290-1299","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":86,"title":["Long\u2010term evaluation (20 years) of the outcomes of subepithelial connective tissue graft plus coronally advanced flap in the treatment of maxillary single recession\u2010type defects"],"prefix":"10.1002","volume":"89","author":[{"given":"Giovan Paolo","family":"Pini Prato","sequence":"first","affiliation":[{"name":"Tuscany Academy of Dental Research (ATRO)  Florence 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