Non-Cochrane · intervention · PM42675471
Efficacy of combined periodontal-restorative treatment versus periodontal treatment alone for gingival recession associated with non-carious cervical lesions: a systematic review and meta-analysis.
Arbildo-Vega Heber Isac, Coronel-Zubiate Franz Tito, Cruzado-Oliva Fredy Hugo, et al. · BMC oral health · 2026 · PubMed · doi:10.1186/s12903-026-09404-1
Findings
Population Adults with gingival recession associated with non-carious cervical lesions
12 findings
| Coronally advanced flap and connective tissue graft with cervical restoration | Coronally advanced flap and connective tissue graft without cervical restoration | Keratinized tissue thickness range 1 year to 2 years · Brazil | MD 0.13 [-0.07, 0.32] Low Downgraded: risk of bias, imprecision 3 studies · 112 participants |
| Coronally advanced flap and connective tissue graft with cervical restoration | Coronally advanced flap and connective tissue graft without cervical restoration | Gingival recession range 1 year to 2 years · Brazil | MD 0.24 [-0.41, 0.89] Low Downgraded: risk of bias, imprecision 3 studies · 112 participants |
| Coronally advanced flap and connective tissue graft with cervical restoration | Coronally advanced flap and connective tissue graft without cervical restoration | Dentin sensitivity 1 year · Brazil | OR 9.25 [2.39, 35.77] 367 [194, 425] per 1000 Low Downgraded: risk of bias, imprecision 2 studies · 76 participants |
| Coronally advanced flap and connective tissue graft with cervical restoration | Coronally advanced flap and connective tissue graft without cervical restoration | Keratinized tissue width range 1 year to 2 years · Brazil | MD -0.04 [-0.44, 0.36] Low Downgraded: risk of bias, imprecision 3 studies · 112 participants |
| Coronally advanced flap and connective tissue graft with cervical restoration | Coronally advanced flap and connective tissue graft without cervical restoration | Aesthetic evaluation of the patient 1 year · Brazil | MD 0.01 [-0.56, 0.58] Low Downgraded: risk of bias, imprecision 2 studies · 76 participants |
| Coronally advanced flap and connective tissue graft with cervical restoration | Coronally advanced flap and connective tissue graft without cervical restoration | Aesthetic evaluation of the professional range 1 year to 2 years · Brazil | MD -1.11 [-3.44, 1.22] Very low Downgraded: risk of bias, imprecision, inconsistency 2 studies · 72 participants |
| Coronally advanced flap and connective tissue graft with cervical restoration | Coronally advanced flap and connective tissue graft without cervical restoration | Probing depth range 1 year to 2 years · Brazil | MD 0.47 [0.14, 0.8] Low Downgraded: risk of bias, inconsistency 3 studies · 112 participants |
| Coronally advanced flap and connective tissue graft with cervical restoration | Coronally advanced flap and connective tissue graft without cervical restoration | Complete root coverage range 1 year to 2 years · Brazil | OR 1.09 [0.41, 2.91] 14 [-185, 129] per 1000 Low Downgraded: risk of bias, imprecision 3 studies · 112 participants |
| Coronally advanced flap and connective tissue graft with cervical restoration | Coronally advanced flap and connective tissue graft without cervical restoration | Clinical attachment level range 1 year to 2 years · Brazil | MD 0.56 [-0.18, 1.3] Low Downgraded: risk of bias, imprecision 3 studies · 112 participants |
| Coronally advanced flap and connective tissue graft with cervical restoration | Coronally advanced flap and connective tissue graft without cervical restoration | Combined defect height 1 year · Brazil | MD 0.23 [-0.08, 0.54] Low Downgraded: risk of bias, imprecision 2 studies · 76 participants |
| Coronally advanced flap and connective tissue graft with cervical restoration | Coronally advanced flap and connective tissue graft without cervical restoration | Root coverage range 1 year to 2 years · Brazil | MD 1.61 [-4.5, 7.72] Low Downgraded: risk of bias, imprecision 2 studies · 76 participants |
| Coronally advanced flap and connective tissue graft with cervical restoration | Coronally advanced flap and connective tissue graft without cervical restoration | Combined defect coverage range 1 year to 2 years · Brazil | MD -6.32 [-13.4, 0.75] Low Downgraded: risk of bias, imprecision 3 studies · 112 participants |
Included primary studies 4
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Santamaria 2013 Randomized controlled clinical trial evaluating connective tissue graft plus resin-modified glass ionomer restoration for the treatment of… PMID:23368948 | 2013 | this review only | not stated | not extracted yet |
| Santamaria 2014 Esthetic evaluation of different approaches to treat gingival recession associated with non-carious cervical lesion treatment: a 2-year… PMID:25831606 | 2014 | this review only | not stated | not extracted yet |
| Santamaria 2016 Resin composite plus connective tissue graft to treat single maxillary gingival recession associated with non-carious cervical lesion:… PMID:26847486 | 2016 | this review only | not stated | not extracted yet |
| Santamaria 2018 Treatment of single maxillary gingival recession associated with non-carious cervical lesion: Randomized clinical trial comparing… PMID:29681059 | 2018 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Healthy adults (over 18 years) with gingival recession associated with non-carious cervical lesions | Adults with single maxillary gingival recession and NCCL (n=36 to 40 per trial) |
| Intervention | Combined periodontal-restorative treatment (CAF + CTG + composite resin or RMGIC) | CAF + CTG + composite resin (2 trials) or RMGIC (2 trials) (n=4) |
| Comparison | Periodontal treatment alone (CAF + CTG without restoration) | CAF + CTG alone (n=4) |
| Outcomes | GR, PD, CAL, KTT, KTW, esthetic evaluation, dentin sensitivity, CDH, CDC, RC, CRC | GR, PD, CAL, KTT, KTW, esthetic (patient, professional), DS, CDH, CDC, RC, CRC |
| Study designs | RCTs (parallel or split-mouth) | Parallel RCTs (n=4), Brazil |
| Timing | Minimum follow-up 1 year | Follow-up 1 to 2 years |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Yes | no |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | NRSI: N/A · RCT: Yes | RCT: Yes · NRSI: N/A | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: N/A · RCT: Yes | NRSI: N/A · RCT: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Critically Low | no |