Coronally Positioned Flap for Treatment of Restored Root Surfaces: A 6-Month Clinical Evaluation Juliana Antico Lucchesi,* Vanessa Renata Santos,* Cristiane Mariote Amaral, † Daiane Cristina Peruzzo, ‡ and Poliana Mendes Duarte* Background: The aim of this study was to evaluate clinically the treatment of gingival recession associated with non-carious cervical lesions (NCCLs) by resin modified glass ionomer ce- ment (RMGI) or microfilled resin composite (MRC) and coro- nally positioned flap (CPF) at 6 months following surgery. Methods: Fifty-nine patients were assigned to one of three treatments: root exposure without NCCL treated with CPF (group 1); root exposure with NCCL treated with RMGI resto- ration plus CPF (group 2); or root exposure with NCCL treated with MRC restoration plus CPF (group 3). Clinical measure- ments that were assessed at baseline and at 3 and 6 months after surgery included plaque index (PI), bleeding on probing (BOP); probing depth (PD), recession reduction (RR), clinical attachment level gain (CALG), keratinized tissue height (KTH), keratinized tissue thickness (KTT), percentage of root cover- age (RC), and percentage of restored root coverage (RRC). Results: Intra- and intergroup analyses demonstrated no significant differences in PI, BOP, PD, RR, CALG, KTH, or KTT (P >0.05) among the groups at any time. At 6 months, the mean RC was 80.83% – 21.08% for group 1; the mean RRCs were 71.99% – 18.69% and 74.18% – 15.02% for groups 2 and 3, respectively. There were no statistically significant differences in RRC between groups 2 and 3. Conclusion: All treatments showed root coverage improve- ment without damage to periodontal tissues, supporting the use of CPF for treatment of root surfaces restored with RMGI or MRC as being effective over the 6-month period. J Periodon- tol 2007;78:615-623. KEY WORDS Flap; glass ionomer; resin. T he exposure of root surfaces be- cause of gingival recession may result in tactile and thermal sensi- tivity, esthetic complaints, 1 and root surface carious lesions. 2 Numerous lon- gitudinal human studies demonstrated the efficacy and predictability of different techniques to correct gingival recession esthetically and functionally. 3 Among these techniques, the coronally posi- tioned flap (CPF), solely or combined with other procedures, e.g., subepithelial connective tissue graft (SCTG), has been one of the most widely used pro- cedures in the treatment of Miller Class I gingival recessions. 4-6 Factors such as bone height, biotype of gingival tissue, and anatomy of the ex- posed root surface can have a negative impact on the degree of root coverage after a periodontal plastic surgical proce- dure. 7 In some situations, the exposed root surface can exhibit irregularities and grooves, caries, resorption, or non- carious cervical lesions (NCCLs). 8 These anatomical root surface presentations can impair the mechanical planing that is done prior to the surgical procedure for root coverage; however, root planing is one of the fundamental steps in the root coverage procedure to smooth irregular- ities and grooves and to reduce the con- vexity of the root. 9 NCCLs, classically referred to as abra- sion, erosion, or abfraction, frequently can extend apically underneath the free gingival margin. Based on its etiol- ogy and severity, the most common * Department of Periodontics, Dental Research Division, Guarulhos University, Guarulhos, Sa ˜o Paulo, Brazil. † Department of Restorative Dentistry, Dental Research Division, Guarulhos University. ‡ Department of Prosthodontics and Periodontics, Division of Periodontics, School of Dentistry at Piracicaba, State University of Campinas, Sa ˜o Paulo, Brazil. doi: 10.1902/jop.2007.060380 J Periodontol • April 2007 615