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

Séverine Vincent-Bugnas, Jonathan Laurent, Eve Naman, Mathieu Charbit, Gwenaël Borie, Séverine Vincent-Bugnas, Jonathan Laurent, Eve Naman, Mathieu Charbit, Gwenaël Borie

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.

Keywords: Acellular dermis; Connective tissue; Gingival recession; Oral surgical procedures.

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Copyright © 2021. Korean Academy of Periodontology.

Figures

Figure 1. Clinical views of the control…
Figure 1. Clinical views of the control side: (A) Preoperative view. (B) Connective tissue graft under the tunnel. (C) Immediate postoperative view. (D) 12-month postoperative view. Clinical views of the test side: (E) Preoperative view. (F) Xenogeneic acellular dermal matrix. (G) Immediate postoperative view. (H) 12-month postoperative view.
Figure 2. Mean change from baseline to…
Figure 2. Mean change from baseline to 12 months follow-up, adjusted for additional covariates (patient's age, patient's sex, side of the maxilla, and tooth type). (A) Mean root coverage. (B) Other clinical parameters.
Figure 3. Course of pain VAS score…
Figure 3. Course of pain VAS score with time after surgery.
VAS: visual analog scale.

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Source: PubMed

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