{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:20:45Z","timestamp":1790706045067,"version":"4.1.0"},"reference-count":66,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T00:00:00Z","timestamp":1599609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Clinic Periodontology"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Aim of this systematic review (SR) of randomized controlled trials (RCTs) was to evaluate effect of different flap designs and graft materials for root coverage, in terms of aesthetics, patient satisfaction and self\u2010reported morbidity (post\u2010operative pain\/discomfort).<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>A comprehensive literature search was performed. A mixed\u2010modelling approach to network meta\u2010analysis was utilized to formulate direct and indirect comparisons among treatments for Root Coverage Esthetic Score (RES), with its individual components, and for subjective patient\u2010reported satisfaction and post\u2010operative pain\/discomfort (visual analogue scale (VAS) of 100).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010six RCTs with a total of 867 treated patients (1708 recessions) were included. Coronally Advanced Flap (CAF) + Connective Tissue Graft (CTG) (0.74 (95% CI [0.24, 1.26], <jats:italic>p<\/jats:italic>\u00a0=\u00a0.005)), Tunnel (TUN) + CTG (0.84 (95% CI [0.15, 1.53]), <jats:italic>p<\/jats:italic>\u00a0=\u00a0.01) and CAF\u00a0+\u00a0Graft substitutes (GS) (0.55 (95% CI [0.006, 1.094], <jats:italic>p<\/jats:italic>\u00a0=\u00a0.04)) were significantly associated with higher RES than CAF. No significant difference between CAF\u00a0+\u00a0CTG and TUN\u00a0+\u00a0CTG was detected (0.09 (95% CI [\u22120.54, 0.72], <jats:italic>p<\/jats:italic>\u00a0=\u00a0.77)). Addition of CTG resulted in less natural tissue texture (\u22120.21 (95% CI [\u22120.34, \u22120.08]), <jats:italic>p<\/jats:italic>\u00a0=\u00a0.003) and gingival colour (\u22120.06 (95% CI [\u22120.12, \u22120.03], <jats:italic>p<\/jats:italic>\u00a0=\u00a0.03)) than CAF. CTG techniques were associated with increased morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Connective tissue graft procedures showed highest overall aesthetic performance for root coverage, although graft integration might impair soft tissue colour and appearance. Additionally, CTG\u2010based techniques were also correlated with a greater patient satisfaction and morbidity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jcpe.13346","type":"journal-article","created":{"date-parts":[[2020,7,12]],"date-time":"2020-07-12T14:10:41Z","timestamp":1594563041000},"page":"1403-1415","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":83,"title":["Aesthetic\u2010And patient\u2010related outcomes following root coverage procedures: A systematic review and network meta\u2010analysis"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3781-1715","authenticated-orcid":false,"given":"Francesco","family":"Cairo","sequence":"first","affiliation":[{"name":"Research Unit in Periodontology and Periodontal Medicine Department of Experimental and Clinical Medicine University of Florence Florence 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