Evaluation of recession defects treated with coronally advanced flaps and either recombinant human platelet-derived growth factor-BB plus β-tricalcium phosphate or connective tissue: comparison of clinical parameters at 5 years.
BACKGROUND
In a previously reported split-mouth, randomized controlled trial, Miller Class II gingival recession defects were treated with either a connective tissue graft (CTG) (control) or recombinant human platelet-derived growth factor-BB + β-tricalcium phosphate (test), both in combination with a coronally advanced flap (CAF). At 6 months, multiple outcome measures were examined. The purpose of the current study is to examine the major efficacy parameters at 5 years.


METHODS
Twenty of the original 30 patients were available for follow-up 5 years after the original surgery. Outcomes examined were recession depth, probing depth, clinical attachment level (CAL), height of keratinized tissue (wKT), and percentage of root coverage. Within- and across-treatment group results at 6 months and 5 years were compared with original baseline values.


RESULTS
At 5 years, all quantitative parameters for both treatment protocols showed statistically significant improvements over baseline. The primary outcome parameter, change in recession depth at 5 years, demonstrated statistically significant improvements in recession over baseline, although intergroup comparisons favored the control group at both 6 months and 5 years. At 5 years, intergroup comparisons also favored the test group for percentage root coverage and change in wKT, whereas no statistically significant intergroup differences were seen for 100% root coverage and changes to CAL.


CONCLUSIONS
In the present 5-year investigation, treatment with either test or control treatments for Miller Class II recession defects appear to lead to stable, clinically effective results, although CTG + CAF resulted in greater reductions in recession, greater percentage of root coverage, and increased wKT.
Private practice, Houston, TX.
Michael K
MK
McGuire
E Todd
ET
Scheyer
Mark B
MB
Snyder
D000328:Adult; D000368:Aged; D000077214:Becaplermin; D001672:Biocompatible Materials / Q000627:therapeutic use*; D002130:Calcium Phosphates / Q000627:therapeutic use*; D003116:Color; D003238:Connective Tissue / Q000637:transplantation; D003807:Dentin Sensitivity / Q000145:classification; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000637:transplantation*; D005889:Gingival Recession / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D006801:Humans; D007633:Keratins; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D017622:Periodontal Attachment Loss / Q000145:classification; D010514:Periodontal Pocket / Q000145:classification; D020574:Proto-Oncogene Proteins c-sis / Q000627:therapeutic use*; D011994:Recombinant Proteins; D013524:Surgical Flaps / Q000601:surgery*; D014092:Tooth Root / Q000473:pathology; D016896:Treatment Outcome
D001672:Biocompatible Materials; D002130:Calcium Phosphates; D020574:Proto-Oncogene Proteins c-sis; D011994:Recombinant Proteins; C485817:beta-tricalcium phosphate; D000077214:Becaplermin; D007633:Keratins
Case-comparison studies; connective tissue; gingival recession; guided tissue regeneration; platelet-derived growth factor BB; transplants