Dataset Information

Treatment of multiple gingival recessions with xenogeneic acellular dermal matrix compared to connective tissue graft: a randomized split-mouth clinical trial.

ABSTRACT:

Purpose

The aim of this study was to compare the efficacy of the tunnel technique for root coverage using a new xenogeneic acellular dermal matrix vs. connective tissue grafting (CTG) for the treatment of multiple maxillary adjacent recessions (recession type 1) at 12 months postoperatively.

Methods

This study enrolled 12 patients with at least 3 contiguous, bilateral, symmetrical maxillary gingival recessions (i.e., at least 6 recessions per patient). In total, 74 recessions were treated using the modified coronally advanced tunnel (MCAT) technique combined with a novel porcine-derived acellular dermal matrix (PADM) at 37 test sites or CTG at 37 control sites. The following clinical parameters were measured: recession height, clinical attachment level, width of keratinized tissue, probing depth, recession width, gingival thickness, mean root coverage (MRC), and complete root coverage (CRC). Comparisons between test and control groups were made for pain visual analog scale scores at 14 days.

Results

At 12 months, the MCAT with PADM (test) yielded a statistically significant improvement in all clinical parameters studied. MRC was significantly higher on the control sides (80.6%±23.7%) than on the test sides (68.8%±23.4%). Similarly, CRC was 48.7%±6.8% on the control sides (CTG), in contrast to 24.3%±8.2% on the test sides (PADM). Statistically significant differences were observed in favor of the control sides for all clinical parameters studied. Nevertheless, the MCAT in adjunction with PADM was clearly superior at reducing mean and maximum patient-reported postoperative pain intensity and pain duration in the first week after surgery.

Conclusions

The use of PADM to treat multiple recessions improved clinical parameters at 12 months, but these outcomes were nevertheless poorer than those observed for CTG. However, PADM reduced morbidity, particularly the pain experienced by patients.

Trial registration

ClinicalTrials.gov Identifier: NCT03162016.

SUBMITTER: Vincent-Bugnas S

PROVIDER: S-EPMC8090794 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Background: The importance of esthetics has escalated over the years. The purpose of any perioplastic surgery is to address gingival recession while ensuring predictable root coverage and a pleasing appearance. An array of surgical procedures have been recommended for the management of recession defects. The present study compares the clinical and patient related outcome measures of coronally advanced flap with chorion membrane and connective tissue graft in the management of multiple adjacent gingival recessions. Methods: The study was a prospective randomized controlled trial which included eight systemically healthy patients with an age range of 30-44 years with 36 labial/buccal, multiple adjacent, Cairo's RT1 gingival recession defects, bilaterally. CAF+CM was performed on one side whereas CAF+CTG was performed on the other side. The two groups were compared clinically at three and six months postoperatively. Results: There was statistically significant decrease in recession depth, recession width, probing depth and clinical attachment level in both the groups from baseline to three and six months. However, intergroup comparisons revealed no statistically significant difference. At six months, both groups showed statistically significant improvements in keratinized tissue width and gingival thickness. The gingival thickness of the CAF+CM group increased significantly at three and six months. In terms of root coverage aesthetic score (RES), there was no significant difference observed between the two groups. In terms of patient reported outcome measures (PROMS), patients preferred the CAF+CM technique. Conclusion: Within the limits of the current study, the use of chorion membrane resulted in considerable root coverage and increased gingival thickness. Periodontal regeneration can be facilitated by the distinctive features of the chorion membrane. Coronally advanced flap plus chorion membrane is a novel approach for root coverage procedures.