Gingival Graft-only:
• There is no attached gingiva.
• No enamel defects are present.
• There is Class I or II recession (no loss of interdental bone or soft tissue).
• Papilla length and fullness are adequate.
• Esthetics is important.
Restoration-only:
• There is adequate attached gingiva.
• The defect is mainly in enamel.
• The lesion is deeper than 2 mm horizontally.
• There is sensitivity.
• There is a Class 3 recession (loss of interdental bone height making complete root coverage not possible)
• Esthetics is not of primary importance.
Graft and Restore:
• There is no attached gingiva.
• There is a defect in the enamel and the cementum/dentin.
• There is sensitivity.
• Recession is significant (≥ 2mm).
• Papilla length and fullness are inadequate.
• Esthetics is important.
Here are some informative recent articles describing the combined surgical and restorative approach:
Click here for article: Treating Noncarious Cervical Aesthetic Zone Lesions: Using Acellular Dermal Matrix and Tunnel-Grafting Techniques
Click here for article: Addressing Cervical Class V Lesions
Here is an good article describing the restorative-only technique:
Click here for article: Spear - Treatment of Class V Lesions
Here is an good article describing the combined approah to treat gingival recession:
Click here for article: Interdisciplinary Approach to Treat Cervical Lesions