A 6-month comparative clinical study of a conventional and a new surgical approach for root coverage with acellular dermal matrix.
BACKGROUND
The acellular dermal matrix graft (ADMG) has become widely used in periodontal surgeries as a substitute for the subepithelial connective tissue graft (SCTG). These grafts exhibit different healing processes due to their distinct cellular and vascular structures. Therefore the surgical technique primarily developed for the autograft may not be adequate for the allograft. This study compared the clinical results of two surgical techniques--the "conventional" and a modified procedure--for the treatment of localized gingival recessions with the ADMG.


METHODS
A total of 32 bilateral Miller Class I or II gingival recessions were selected and randomly assigned to test and control groups. The control group received the SCTG and the test group the modified surgical technique. Probing depth (PD), relative clinical attachment level (RCAL), gingival recession (GR), and width of keratinized tissue (KT) were measured 2 weeks prior to surgery and 6 months post-surgery.


RESULTS
Both procedures improved all the evaluated parameters after 6 months. Comparisons between the groups by Mann-Whitney rank sum test revealed no statistically significant differences in terms of CAL gain, PD reduction, and increase in KT from baseline to 6-month evaluation. However, there was a statistically significant greater reduction of GR favoring the modified technique (P = 0.002). The percentage of root coverage was 79% for the test group and 63.9% for the control group.


CONCLUSIONS
We conclude that the modified technique is more suitable for root coverage procedures with the ADMG since it had statistically significant better clinical results compared to the traditional technique.
Barros
Raquel R M
RR
Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
Novaes
Arthur B Júnior
AB
Grisi
Márcio F M
MF
Souza
Sérgio L S
SL
Taba
Mário Júnior
MJ
Palioto
Daniela B
DB
D000328:Adult; D001672:Biocompatible Materials / Q000627:therapeutic use*; D002614:Chelating Agents / Q000627:therapeutic use; D003094:Collagen / Q000627:therapeutic use*; D003238:Connective Tissue / Q000637:transplantation; D004492:Edetic Acid / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology / Q000637:transplantation; D005889:Gingival Recession / Q000145:classification / Q000601:surgery*; D006801:Humans; D008297:Male; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D016745:Root Planing; D013524:Surgical Flaps; D014092:Tooth Root / Q000601:surgery*; D016896:Treatment Outcome
C440568:Alloderm; D001672:Biocompatible Materials; D002614:Chelating Agents; D003094:Collagen; D004492:Edetic Acid