title: Treatment of gingival recession using a collagen membrane with or without the use of demineralized freeze-dried bone allograft for space maintenance.
abstract: BACKGROUND
  Studies utilizing collagen membranes for guided tissue regeneration (GTR)-based root coverage procedures have reported promising results. However, creating and maintaining space underneath the membrane remains a challenge. Therefore, the purpose of this clinical trial was to determine whether the addition of bone graft (i.e., demineralized freeze-dried bone allograft [DFDBA]) significantly affects the outcome of collagen membrane GTR-based root coverage procedures.
  
  
  METHODS
  Twenty patients participated. One Miller's Class I or II recession defect per patient was treated with a collagen membrane covered by a coronally positioned flap. Half of the patients also had DFDBA placed under the membrane. Clinical parameters recorded included: recession depth, recession width, width of keratinized tissue, clinical attachment level, and probing depth, measured to the nearest 0.5 mm. Presurgery and postsurgery (6-month) data were compared using Student's paired t test for parametric data and the Wilcoxon matched pairs test for non-parametric data.
  
  
  RESULTS
  Guided tissue regeneration with collagen (COLL) and collagen + DFDBA (COBA) both resulted in statistically significant (P <0.05) reductions in recession depth (2.1 +/- 0.9 mm and 2.5 +/- 0.5 mm), recession width (1.5 +/- 1.7 mm and 2.2 +/- 1.6 mm), increase in keratinized tissue (0.7 +/- 0.8 mm and 1.2 +/- 1.0 mm), and gain of clinical attachment level (2.1 +/- 1.0 mm and 3.0 +/- 1.0 mm), when comparing 6-month data to baseline. Mean root coverage was 68.4 +/- 15.2% with COLL and 74.3 +/- 11.7% with COBA. However, there were no statistically significant differences between groups for recession depth, recession width, width of keratinized tissue, clinical attachment level, and probing depth.
  
  
  CONCLUSIONS
  Both techniques are effective in attaining root coverage. Although root coverage tended to be better with the addition of DFDBA, the difference was not statistically significant. Further studies with a larger sample size are needed to determine whether adding DFDBA to GTR-based procedures using collagen membranes is of any benefit.
authors.affiliation: Department of Periodontics/Prevention/Geriatrics, School of Dentistry, University of Michigan, Ann Arbor, MI 48109-1078, USA.
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Kimble
authors.forename: Robert M
authors.initials: RM
authors.lastname: Eber
authors.forename: Stephen
authors.initials: S
authors.lastname: Soehren
authors.forename: Yu
authors.initials: Y
authors.lastname: Shyr
authors.forename: Hom-Lay
authors.initials: HL
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D016025:Bone Transplantation; D003094:Collagen; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology; D005889:Gingival Recession / Q000473:pathology / Q000601:surgery*; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008567:Membranes, Artificial; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000145:classification; D010514:Periodontal Pocket / Q000145:classification; D018709:Statistics, Nonparametric; D013524:Surgical Flaps; D014092:Tooth Root / Q000473:pathology
chemical_list: D008567:Membranes, Artificial; D003094:Collagen