Clinical evaluation of Miller class I and II recessions treatment with the use of modified coronally advanced tunnel technique with either collagen matrix or subepithelial connective tissue graft: A randomized clinical study

Abstract

Aim To compare outcomes of modified coronally advanced tunnel technique (MCAT) combined with either collagen matrix (CM) or subepithelial connective tissue graft (SCTG) in the treatment of Miller class I and II multiple gingival recessions in the mandible. Materials and methods The study encompassed 91 recessions in 29 patients for whom MCAT was combined with CM on one side of the mandible and SCTG on the contralateral one. The following clinical parameters were measured: gingival recession height (GR) and width (RW), probing depth (PD), clinical attachment level (CAL), width of keratinized tissue (KT), gingival thickness (GT), mean (MRC) and complete root coverage (CRC) and Root Coverage Esthetic Score (RES). Results The MRC proportions on the CM‐ and SCTG‐treated sides were 53.20% and 83.10%, respectively. CRC was achieved in 9 out of 45 (20%) gingival defects treated with CM and 31 out of 46 (67%) treated with SCTG. There were statistically significant differences in MRC, CRC, GR, RW, KT, GT and RES between CM‐ and CTG‐treated sides. Conclusions Modified coronally advanced tunnel technique leads to reduction in gingival recession both when combined CM and SCTG, of which the latter is more efficient as far as root coverage and aesthetic parameters are concerned.

Xenogeneic collagen matrix versus connective tissue graft for the treatment of multiple gingival recessions: A systematic review and meta‐analysis

“…The age of the participants ranged from 18 to 50 years with a follow‐up period ranging from 3 months to 5 years. All included studies (Table ) compared CMX with CTG for the treatment of MAGR (Aroca et al, ; Cieślik‐Wegemund, Wierucka‐Młynarczyk, Tanasiewicz, & Gilowski, ; Pietruska, Skurska, Podlewski, Milewski, & Pietruski, ; Tonetti et al, ).…”

“…All studies clearly included MAGR with Class I and II Miller's GR. Three studies involved both maxillary and mandibular teeth (Aroca et al, ; Cieślik‐Wegemund et al, ; Tonetti et al, ), whereas one study reported only mandibular teeth (Pietruska et al, ). The remaining did not mention which arches were treated.…”

“…Recessions were also surgically treated with a variation of techniques. One study performed CAF (Tonetti et al, ) whereas other two performed modified coronally advanced tunnel (MCAT; Aroca et al, ; Pietruska et al, ). Only one study reported the application of TUN to cover both grafts (Cieślik‐Wegemund et al, ).…”

“…In terms of postoperative management, all patients in three studies reported prescription of chlorhexidine mouth rinse after the surgery with a usage range between 5 and 21 days with two different concentrations either 0.2% (Aroca et al, ; Pietruska et al, ) or 12% (Cieślik‐Wegemund et al, ). On the other hand, one study instructed their patients to use 0.5% chlorhexidine gel on the first week (Tonetti et al, ).…”

“… Probing depth (PD) Change in “PD” was reported in three studies (Aroca et al, ; Cieślik‐Wegemund et al, ; Pietruska et al, ). The Cochran's Q is lower and not statistically significant (Q = 2.682, p = .262) and I 2 value (25.43%) also lower, which implies lack of heterogeneity across the three studies.…”