The aim of this study was to evaluate root coverage of gingival recessions and to compare graft vascularization in smokers and non-smokers.Methods:
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.Results:
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).Conclusion:
Root coverage with subepithelial connective tissue graft was negatively affected by smoking, which limited and jeopardized treatment results. J Periodontol 2008;79: 1014–1021.