Relationship between the gingival biotype and the results of root covering surgical procedures: A systematic review

Abstract

Background: Tissue biotypes are related to the results of periodontal therapy, conventional prosthodontics, implant therapy and root covering procedures. We conducted a systematic review (SR) of the literature about the relationship between the gingival biotype and the results of root covering surgical procedures. Material and Methods: A PICO question was defined. Two independent reviewers conducted electronic and manual literature searches, which covered studies up to August 31, 2020, in the National Library of Medicine (PubMed MEDLINE), EBSCO, Science Direct and Cochrane. The inclusion criteria were all root covering procedures in individuals with different gingival biotypes. The final result of the different surgical techniques was evaluated by the Root Coverage Esthetic Score (RES). The Methodological Index for the identification of biases for Non-Randomized Studies was applied. Results: Only four articles fulfilled the inclusion criteria. These studies adequately reported the percentage of root coverage after surgery, and two recorded the entire RES index. Complete root coverage was achieved in a range between 70 - 86.12% in patients with thin biotype and between 77.8 - 96% in patients with a thick biotype. The aesthetic results were not compromised by the initial classification of the biotype. The treatments used were subepithelial connective tissue graft with coronally displaced flap or its modification. No significant differences were found. Conclusions: When the gingival biotypes are analyzed as independent variables, none of the root coverage procedures are affected by the classification of the gingival biotype