Efficacy of microsurgery in comparison to macrosurgery for the treatment of localized gingival recession using coronally advanced flap: A systematic review and meta-analysis.

[BACKGROUND] The standard approach to treating gingival recession (GR) has traditionally been macrosurgery. However, the adoption of microsurgical techniques has significantly benefited periodontal plastic surgery due to their high precision and minimal invasiveness.

[OBJECTIVES] To assess the effectiveness of microsurgery versus macrosurgery in the treatment of isolated GR using a coronally advanced flap (CAF).

[MATERIALS AND METHODS] A systematic literature search was conducted across four databases; PubMed, Google Scholar, ProQuest, and Cochrane, along with a hand search of relevant scientific journals. The focused question was whether the microsurgical technique more effective than the conventional scalpel technique in achieving better clinical outcomes for treating isolated GR with a CAF. The primary outcome was recession depth (RD) and the secondary outcomes included recession width, clinical attachment level and width of keratinized tissue. Statistical analysis was performed using Stata 16.

[RESULTS] A meta-analysis of the eight included studies revealed statistically significant results in terms of overall mean RD at baseline and endpoint which was 2.43 mm and 0.63 mm, respectively, favoring the microsurgical group. The microsurgical technique demonstrated greater effectiveness than the conventional scalpel technique in achieving improved clinical outcomes when treating isolated GR with a CAF.

[CONCLUSION] The microsurgical approach for root coverage achieved superior clinical outcomes with a CAF compared to the conventional macrosurgical method due to its precision and minimal encroachment at the operative site.