Subepithelial Connective Tissue Graft for Root Coverage in Smokers and Non-Smokers: A Clinical and Histologic Controlled Study in Humans

    loading  Checking for direct PDF access through Ovid



The aim of this study was to evaluate root coverage of gingival recessions and to compare graft vascularization in smokers and non-smokers.


Thirty subjects, 15 smokers and 15 non-smokers, were selected. Each subject had one Miller Class I or II recession in a non-molar tooth. Clinical measurements of probing depth (PD), relative clinical attachment level (CAL), gingival recession (GR), and width of keratinized tissue (KT) were determined at baseline and 3 and 6 months after surgery. The recessions were treated surgically with a coronally positioned flap associated with a subepithelial connective tissue graft. A small portion of this graft was prepared for immunohistochemistry. Blood vessels were identified and counted by expression of factor VIII-related antigen-stained endothelial cells.


Intragroup analysis showed that after 6 months there a was gain in CAL, a decrease in GR, and an increase in KT for both groups (P <0.05), whereas changes in PD were not statistically significant. Smokers had less root coverage than non-smokers (58.02% ± 19.75% versus 83.35% ± 18.53%; P <0.05). Furthermore, the smokers had more GR (1.48 ± 0.79 mm versus 0.52 ± 0.60 mm) than the non-smokers (P <0.05). Histomorphometry of the donor tissue revealed a blood vessel density of 49.01 ± 11.91 vessels/200× field for non-smokers and 36.53 ± 10.23 vessels/200× field for smokers (P <0.05).


Root coverage with subepithelial connective tissue graft was negatively affected by smoking, which limited and jeopardized treatment results. J Periodontol 2008;79: 1014–1021.

Related Topics

    loading  Loading Related Articles