De-epithelialized free gingival graft versus subepithelial connective tissue graft in the treatment of gingival recession: a systematic review and meta-analysis

Background: The best technique to harvest gingival graft to treat gingival recessions (GR) remains a topic of ongoing debate. This systematic review aimed to evaluate the effect of de-epithelialized free gingival graft (DFGG) compared to subepithelial connective tissue graft (SCTG) in the treatment of GR Miller Class I and II or Cairo type I. Material and Methods: Five databases were searched up to June 2024 to include randomized clinical trials (RCTs) comparing the clinical effects of DFGG with SCTG in the treatment of GR. The random effects model of mean differences was used to determine GR, and gain in keratinized tissue width (KTW), gingival thickness (GT) and clinical attachment level (CAL). The risk ratio was used to complete root coverage (CRC) at 6 and 12 months. Results: Five RCTs including 183 and 111 GR at 6 and 12 months were included in this systematic review. The meta-analysis showed no statistically significant difference in GR reduction, gain in KTW, GT, CRC or CAL between groups at 6 and 12 months. Conclusions: At 12 months, the clinical results of DFGG were similar to those of SCTG in the treatment of GR.