A comparative clinical evaluation of acellular dermal matrix allograft and sub-epithelial connective tissue graft for the treatment of multiple gingival recessions

Abstract

Background:Obtaining predictable and aesthetic root coverage has become an important part of periodontal therapy. Several techniques have been developed to obtain these results with variable outcomes. The aim of this study was to compare and evaluate the effectiveness of acellular dermal matrix allograft (ADMA) and subepithelial connective tissue graft (SCTG) in combination with coronally positioned flap in the treatment of multiple gingival recessions in aesthetic areas.Materials and Methods:Total 10 patients were selected for this study, aged between 18 to 40 years and were randomly assigned to one of the groups ADMA and SCTG. The clinical parameters including probing pocket depth, clinical attachment level, gingival recession, width of keratinized tissue were recorded at baseline and at 6 months after surgery and data was statistically analyzed.Results:No significant differences in gingival recession reduction were noted between ADMA and gold - standard SCTG. Within limits of this clinical study, the use of ADMA may represent an acceptable alternative to the SCTG for treating gingival recession. The use of ADMA eliminates the need for the palatal donor site thus represents a less invasive surgery for treating multiple gingival recessions.Conclusions:These results suggest that ADMA may be a useful substitute instead of subepithelial connective tissue graft for root coverage.

A Preliminary Clinical Comparison of the Use of Fascia Lata Allograft and Autogenous Connective Tissue Graft in Multiple Gingival Recession Coverage Based on the Tunnel Technique

“…ARC was 95.77 ± 0.11% for the control group and 94.21 ± 0.20% for the test group. These observations are in accordance with other papers comparing the use of ADMA and CTG in cases of both individual and multiple gingival recession coverage using different operating techniques [27][28][29]. On the other hand, they contradict other studies which showed statistically better results when a connective tissue graft was applied [11,30].…”

“…Rahmani et al [30] observed mean root coverage of 70% for SCTG and 70% for the ADMA group. Similarly, Koudale et al [27] did not observe any statistically significant differences 6 months after multiple gingival recession coverage procedures using CPF with ADMA and CTG. In this case, the mean percent root coverage achieved was 94% and 97%, respectively.…”

“…At each treated tooth single sling mattress sutures were placed. They were removed 2 weeks afterwards in the case of the control group just as in Ayub et al [26], Koudale et al [27], and after 3 weeks in the case of the test group. A comparison of multiple gingival recession coverage procedures performed with the tunnel method using fascia lata Allograft as well as autogenous connective tissue graft indicates that similar clinical results were achieved at the end of a 6-month observation period.…”

Root Coverage Procedures for Multiple Recession Defects

“…Cairo et al confirmed this and showed that the treatment results of the MCAF alone vs. MCAF plus SCTG procedures were similar at sites with thick gingiva (>0.8 mm) but the SCTG improved results at sites with thin tissue [14]. In two studies, acellular dermal matrix allograft (ADM, AlloDerm®, BioHorizons) reduced gingival recession by at least 90% and showed no statistically significant difference from SCTG groups [15,27]. The efficacy of enamel matrix derivative (EMD, Emdogain®, Straumann) was compared to that of SCTG in two studies.…”

“…Studies using subepithelial connective tissue graft (SCTG) on multiple Miller Class I and II gingival recession defects show mean percent root coverage ranging from 77 to 98%, with only 4 out of 17 studies reporting less than 90% [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Other than coronally positioned flaps, flap designs used include tunnel technique [12,13], modified coronally advanced tunnel (MCAT) technique [26], modified coronally advanced flap (MCAF) technique by Zucchelli and De Sanctis [17,29], and a modified coronally positioned flap with a horizontal incision in the alveolar mucosa [20].…”