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Introduction: A variety of surgical techniques have been used to cover recession type defects. Yet, improving the results of root coverage techniques for Miller class III and IV recession defects is a matter of concern. Objective: The present study aimed at evaluating the clinical outcome following treatment of localized gingival recessions (including Miller class III and IV) by six different grafting procedures. Materials and Methods: Twenty patients with overall twenty-seven Miller classes I to IV Buccal gingival recessions participated in this study, from the year 1379 to I381. After completing the phase I periodontal therapy for all the patients, following clinical variables were recorded: The apical extent of the gingival recession, the width of the recession defect measured at the Cemeto-enamel junction (CEJ), as well as probing depth and attachment level. Results: All grafting procedures resulted in a significant gain (p<0.005) of root coverage and statistically significant reduction in probing depth and gain of attachment level (p<0.005). Conclusions: All six grafting procedures evaluated in this study offer predictable and convenient approach as root coverage procedures in Miller class I and II recession defects. Combining pedicle grafts with free connective tissue grafts (combined procedures) seems to improve the results following surgical treatment of Miller class III, IV and wide class II recession defects.

Keywords: Gingival Diseases, Gingival Recession

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