The effect of enamel matrix derivatives on root coverage: a 12-month follow-up of a randomized clinical trial

Abstract

Subepithelial connective tissue grafts (SCTGs) with a coronally advanced flap (CAF) are accepted as the gold standard for covering denuded root surfaces. In recent years, enamel matrix derivatives (EMDs) have been used for their regenerative potential in periodontics. The aim of this split-mouth and randomized controlled study was to assess the clinical and aesthetical impacts of EMD application in combination with SCTG+CAF in patients with Miller's Class I and II gingival recessions in contralateral canines of the maxilla. Participants who underwent SCTG+CAF+EMD application were identified as the test group (n = 19) and those who underwent SCTG+CAF as control group (n = 19). The outcome parameters were recession depth/width, root coverage percentage, and root coverage aesthetic score (RES). RES was evaluated by two calibrated blind periodontists one year after the treatment. Statistically significant root coverage percentage was observed at one year post-treatment for both groups (p < 0.05). However, significant differences between the groups were not observed in terms of total RES and complete root coverage rate (p > 0.05). The test group had significantly better results than the control according to the soft tissue texture and mucogingival junction alignment results (p < 0.05). These results indicate that EMDs contribute to the healing of soft tissue without scarring. As a result of better wound healing, the EMD-added group exhibited better results in terms of the harmony of the mucogingival junction between adjacent teeth. This paper is the first split-mouth study in which SCTG+CAF and SCTG+CAF+EMD were compared using RES in bilateral canines.

Tunnel technique with enamel matrix derivative in addition to subepithelial connective tissue graft compared with connective tissue graft alone for the treatment of multiple gingival recessions: a randomized clinical trial

“…Insufficient clinical studies comparing esthetic outcomes using RES in MCAT+SCTG with and without EMD prevent cross-referencing and drawing definitive conclusions on its beneficial effect. It is worthy to mention that the esthetic impact of EMD application in combination with SCTG+CAF in bilateral canine Miller class I or II gingival recessions was recently assessed [30]. Whereas there was no difference between two treatment modalities in terms of total RES and complete root coverage, the test group had significantly better results with regard to soft-tissue texture and MGJ alignment.…”

Aesthetic‐And patient‐related outcomes following root coverage procedures: A systematic review and network meta‐analysis

“…The α and β fixed parameters capture the common intercept and common trend for all study arms with a given treatment type; θ , η and γ are random effects that capture study, study arm unique intercepts and a study unique time slope; and ϵ reflects all other sources of variation. P i is 1 for a study of parallel design and 0 for any split‐mouth trial that contributed to the analysis with both treatment arms (Aydinyurt, Tekin, & Ertugrul, 2019, Jhaveri et al, 2010, Milinkovic et al., 2015, Pietruska, Skurska, Podlewski, Milewski, & Pietruski, 2019, Stefanini et al., 2016). All other model components are random and capture study‐specific effects.…”

Effect of Root Surface Biomodification on Multiple Recession Coverage with Modified Coronally Advanced Tunnel Technique and Subepithelial Connective Tissue Graft: A Retrospective Analysis

“…We previously described similar soft tissue response to root surface modification with either EDTA or EDTA + EMD [ 12 , 22 ], but no other researchers provided results that could be directly compared with ours. However, Aydinyurt et al [ 39 ] assessed the impact of EMD application on esthetic outcomes of CAF + SCTG in treatment of Miller class I and II gingival recessions of contralateral maxillary canines. Despite the fact that no differences were observed between two treatment modalities in terms of total RES and CRC, the EMD group had significantly better results with regard to soft tissue texture and muco-gingival junction alignment.…”