{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:02:22Z","timestamp":1789988542184,"version":"4.0.1"},"reference-count":110,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,9,28]],"date-time":"2025-09-28T00:00:00Z","timestamp":1759017600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,9,28]],"date-time":"2025-09-28T00:00:00Z","timestamp":1759017600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Periodontal Research"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To answer the focused PEOS question: In animals or humans with gingival recession defects (P) what are the histological outcomes (O) of different root coverage procedures (RCPs) (E) in preclinical or clinical studies (S)?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Electronic databases (MEDLINE, EMBASE, CENTRAL) were searched for eligible studies reporting histological outcomes of RCPs in large\u2010animal models or humans. Histomorphometric data from animal studies were summarized as pooled means (PM) for each RCP and compared between different RCPs using effect sizes (ES) based on random\u2010effects meta\u2010analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 41 preclinical (32 canine\u2010, 5 porcine\u2010, 4 primate\u2010models) and 43 clinical studies, mostly case reports\/series, were included. The most frequently reported RCPs were coronally advanced flaps with or without connective tissue grafts or soft\u2010tissue substitutes. Biologicals, such as enamel matrix derivatives (EMD) or membranes, were sometimes used as adjuncts in RCPs. In human biopsies, healing following RCPs mostly occurred via the formation of long junctional epithelium (JE) and connective tissue (CT) adhesion. Some degree of periodontal regeneration was reported in half of the studies. In canine studies with experimentally created defects and limited observation times, PM of new bone, cementum, and CT attachment ranged from 0.17 to 0.50, 0.97 to 2.39, and 1.31 to 2.47, respectively. Meta\u2010analyses revealed significantly greater new cementum with inserting fibers when using biologicals, particularly EMD (ES 0.86\u20130.92), or membranes (ES 0.87) as adjuncts in RCPs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Healing following RCPs is generally characterized by \u201crepair\u201d (long JE and CT adhesion). Based on animal studies, the adjunctive use of biologicals or membranes in RCPs may enhance periodontal regeneration at least in the short term.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO: CRD42024628844<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jre.70043","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T06:52:02Z","timestamp":1759128722000},"page":"9-29","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Histological Outcomes of Root Coverage Procedures: A Systematic Review With Meta\u2010Analysis"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0056-8379","authenticated-orcid":false,"given":"Siddharth","family":"Shanbhag","sequence":"first","affiliation":[{"name":"Department of Periodontology Faculty of Dentistry, University of Oslo  Oslo Norway"},{"name":"Department of Immunology and Transfusion Medicine Haukeland University Hospital  Bergen Norway"},{"name":"Center for Translational Oral Research (TOR), Department of Clinical Dentistry Faculty of Medicine, University of Bergen  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida Hauk\u00e5en","family":"St\u00f8dle","sequence":"additional","affiliation":[{"name":"Department of Periodontology Faculty of Dentistry, University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stein Atle","family":"Lie","sequence":"additional","affiliation":[{"name":"Center for Translational Oral Research (TOR), Department of Clinical Dentistry Faculty of Medicine, University of Bergen  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6293-5755","authenticated-orcid":false,"given":"Mariano","family":"Sanz","sequence":"additional","affiliation":[{"name":"Department of Periodontology Faculty of Dentistry, University of Oslo  Oslo Norway"},{"name":"ETEP Research Group University Complutense of Madrid  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4862-9030","authenticated-orcid":false,"given":"Anders","family":"Verket","sequence":"additional","affiliation":[{"name":"Department of Periodontology Faculty of Dentistry, University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1996.tb00608.x"},{"issue":"27","key":"e_1_2_7_3_1","first-page":"72","article-title":"The Use of Free Gingival Grafts for Aesthetic Purposes","volume":"2001","author":"Camargo P. 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