Coverage of Miller class I and II recession defects using enamel matrix proteins versus coronally advanced flap technique: a 2-year report.
BACKGROUND
The aim of this study was to evaluate a comparison of the coronally advanced flap procedure with or without the use of enamel matrix proteins in the treatment of recession defects.


METHODS
This 2-year study was conducted as a blinded, split-mouth, placebo-controlled, and randomized design. Thirty patients from two dental schools with two paired buccal recession defects were chosen. Surgical recession coverage was performed as the coronally advanced flap technique. One site was additionally treated with derivative (EMD) and the other site with a placebo (propylene glycol alginate [PGA]). A blinded examiner assessed pre- and post-surgical measurements. Measurements comprised the height and width of the gingival recession, height of keratinized tissue, probing attachment level, probing depth, and alveolar bone level.


RESULTS
Twenty-four months after therapy, both treatment modalities showed significant root coverage and probing attachment gain. The mean gingival recession decreased from 3.6 to 0.8 mm for the EMD-treated sites and from 3.8 to 1.4 mm for the control sites. However, this difference was not statistically significant (P = 0.122). Similarly, all other clinical parameters did not differ significantly in the between-group comparison except for the recession width (P = 0.027) and probing depth (P = 0.046) exhibiting higher reductions in the EMD group. Complete root coverage could be maintained over 2 years in 53% of the EMD versus merely 23% in the control group. A total of 47% of the treated recessions in the control group deteriorated again in the second year after therapy compared to 22% in the EMD group.


CONCLUSIONS
Enamel matrix derivative seems to provide better long-term results.
Spahr
Axel
A
Conservative Dentistry and Periodontology, University of Ulm, Ulm, Germany. axel.spahr@uniklinik-ulm.de
Haegewald
Stefan
S
Tsoulfidou
Fotini
F
Rompola
Eirini
E
Heijl
Lars
L
Bernimoulin
Jean-Pierre
JP
Ring
Christina
C
Sander
Silvia
S
Haller
Bernd
B
D000328:Adult; D000539:Alveolar Process / Q000473:pathology; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology; D005889:Gingival Recession / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000473:pathology; D010514:Periodontal Pocket / Q000473:pathology; D010919:Placebos; D012008:Recurrence; D016037:Single-Blind Method; D013524:Surgical Flaps; D014092:Tooth Root / Q000473:pathology; D016896:Treatment Outcome
D003746:Dental Enamel Proteins; D010919:Placebos; C109069:enamel matrix proteins