Amnion and Chorion Allografts in Combination with Coronally Advanced Flap in the Treatment of Gingival Recession: A Clinical Study

Abstract

Background: Guided tissue regeneration (GTR) based root coverage using different allograft membranes has been utilized to correct gingival recession defects with promising results. Amnion and chorion allograft membranes of alternative origin derived from human placental tissue has been advocated in the treatment of gingival recession. However, chorion membrane has been used in combination with amnion membrane no study has compared these allograft membranes in the treatment of gingival recession. Therefore, the purpose of this study was to clinically evaluate and compare the efficacy of amnion membrane and chorion membrane in combination with coronally advanced flap in the treatment of gingival recessions.

Materials and methods: Twelve systemically healthy patients having at least 2 bilateral Miller's Class I or Class II gingival recession were recruited and coronally advanced flap was performed with amnion membrane or chorion membrane. Clinical parameters such as gingival Index, plaque index, length of the recession, width of the recession, width of keratinized gingiva, relative attachment level were evaluated at baseline, 3 and 6 months post-surgery.

Results: The mean decrease in length of recession (LR) for Chorion site was 2.00±1.54mm and amnion site was 1.58±1.14mm. The gain in attachment level for amnion site was 2.17±1.53mm and for chorion site was 1.58±1.22mm. The total mean percentage of root coverage was 34% for chorion site and 22% for amnion site.

Conclusion: Both amnion membrane and chorion membrane has shown to be versatile allograft material to be used in the treatment of root coverage.

Keywords: Aesthetics; Amnion membrane; Chorion membrane; Gingival recession; Periodontal plastic surgery; Root coverage.

Figures

[Table/Fig-1]:

(a) Preoperative recession defect (b) Amnion membrane (c) Amnion membrane placed (d) Flap coronally sutured (e)10 days postop (f) Immediate after suture removal (g) 10 days post op months post surgery (g-i) 1, 3 and 6 months

[Table/Fig-2]:

(a) Preoperative recession defect (b) Chorion membrane (c) Chorion membrane placed (d) Flap coronally sutured (e)10 days post op (f) Immediate after suture removal (g)10 days post op months post surgery (g-i) 1, 3 and 6 months

[Table/Fig-5]:

Difference in Length of recession(LR), Width of recession(WR) and width of Keratisnised gingiva from base line to 1,3 and 6 months in Group I and II By Wilcoxon Signed Rank test

[Table/Fig-7]:

Comparison of two groups with respect to: a) Length of recession (LR); b) width of recession C)Width of Keratinised gingiva by Mann Whitney U-test

[Table/Fig-9]:

Mean percentage (%) of Root coverage in both the groups