Long‐term evaluation (up to 7 years) of the use of a collagen matrix to treat gingival recession associated with noncarious cervical lesion: Report of two cases

Abstract

Introduction: Gingival recession (GR) is a relevant clinical condition due to its high prevalence worldwide, which leads to aesthetic demands and dentin hypersensitivity. Collagen matrices have been associated with different designs of coronally advanced flaps (CAFs) to treat GR defects. However, the literature lacks long-term follow-up of this treatment option. The aim of this study is to present the longterm follow-up (up to 7 years) of two GR defects (associated or not with noncarious cervical lesion) treated with a CAF and a collagen matrix (CM). Case presentation: Case 1 underwent a CAF associated with a CM to treat a single GR defect. After 7 years, Case 1 presented with 3 mm of recession reduction, which corresponds with the 85.7% of root coverage. Case 2 presented two GR defects associated with noncarious cervical lesions (NCCLs). The NCCLs were partially restored with resin composite and then underwent a modified CAF for multiple defects and a CM. After 5 years of follow-up, Case 2 presented with 1.5 and 2.5 mm of recession reduction, which corresponds with the average 83.3% defect coverage. Conclusion: These two cases may show that CMs can provide long-term stable outcomes in the treatment of GR defects. K E Y W O R D S biocompatible materials, esthetics, dental, gingival recession, tooth abrasion, tooth cervixWhy is this case new information? • One of the cases is the first one to describe a 7 years of follow-up after CAF+CM to treat gingival recession defects.What are the keys to successful management of this case?• Correct material handling.• Adequate restorative protocol and surgical technique.What are the primary limitations to success in this case?• Diagnose • Patient compliance.

Current state about root coverage using soft-tissue substitutes in the presence of noncarious cervical lesions: A literature review

“…Among them, four studies used CM. [ 19 , 37 , 39 , 40 ] One case report employed VCM,[ 36 ] and three studies utilized ADMG. [ 20 , 38 , 41 ]…”

“…[ 20 , 41 ] On the other hand, the most studies restored the defects and employed direct composite resin restorations. [ 19 , 36 , 37 ] Among them, Santamaria’s group placed restorations 1 mm apically at the calculated CEJ level,[ 19 , 36 , 39 ] and Martiniello et al . finalized them at the level of MRC.…”

“…In addition, three studies placed the apical border of the resin composite restorations 1 mm apically to the predicted CEJ. [ 19 , 36 , 39 ] This way, they reduce the likelihood of residual root exposure and minimize the persistent DH. [ 45 ]…”

“…mentioned that ECAF is a suitable technique for treating CDs and in association with STSs because ECAF provides a better nutrition for the avascular graft. [ 20 ] The other studies employed the conventional CAF technique plus STSs[ 19 , 36 - 39 ] and tunnel technique plus STSs. [ 40 , 41 ]…”