Introduction: Factors that may influence the outcome of root coverage surgery include: anatomical characteristics, such as bone height, size of interdental papilla, defect size, flap thickness, and tooth location; other patient-related factors, such as smoking and systemic diseases; and also surgical/technical factors. Objective: This study presents a review of the literature and examines aspects related to patients that may influence the outcome of periodontal plastic surgery. Material and Methods: PubMed databases were searched with no restrictions with regard to date or language. Lists of eligible studies were then searched by hand. The research was conducted by a single author using the keywords “periodontium” or “gingival recession” and “surgical flaps” or “plastic surgery”. The reviewer selected the main studies related to the subject based on the title, the abstract and a full reading. Those that were not relevant were excluded. Results: A total of 29,704 studies were found. The most relevant studies in English were included based on a reading of the title and the abstract. Thirty studies were selected after full reading. Conclusion: The surgeon must consider all factors involving anatomical characteristics, behavior, and systemic diseases that may exert an influence during or after the surgical procedure. The degree of recession, gingival thickness, and papilla size may all influence the outcome. Biofilm control is essential subsequent to surgery. Smoking may cause a response to be less satisfactory, especially when, in combination with poor biofilm control, there is a synergistic effect.
