Late complications after root coverage with two types of subepithelial connective tissue grafts, clinical and histopathological evaluation: A prospective cohort study

Aim This prospective cohort study evaluated late complications (LC) on recipient sites comparing two types of connective tissue grafts (CTG). Materials and Methods Participants (n: 60) were treated with coronally advanced flap (CAF) plus CTG harvested by de‐epithelialized technique (DE) (n:31) or two‐parallel incision (PI) (n:29). Areas were evaluated to identify white discharge associated or not with gingival cul‐de‐sac. Patients were ordered in groups with (DE+and PI+) or without (DE‐ and PI‐) LC. Biopsies for histopathological analysis in LC areas were proposed. Results Six cases exhibited LC, 5 in DE graft (DE+) and 1 in PI graft (PI+) group; 2 were diagnosed at 3 months postoperatively, 3 at 6 months and one at 12 months. The relative risk for LC was 1.7 times greater for DE graft (p: 0.01; CI: 1.10 to 2.72; RR>1). Differences were not observed for clinical outcomes after both types of CTGs (p > 0.05). Biopsies showed deep invagination of the epithelial lining suggesting cyst‐like area/ cavity with keratin content and consolidated in fibrous connective tissue. After 24 months biopsied areas presented no recurrence of LC, in non‐biopsied patients the clinical condition remained unchanged. Conclusions Considering the limitations of this study, LC on recipient sites demonstrated no statistical difference between two types of CTG.