A comparative evaluation of the effectiveness of subpedicle acellular dermal matrix allograft with subepithelial connective tissue graft in the treatment of isolated marginal tissue recession: A clinical study

Abstract

Introduction:The most common problem encountered in our day to day practice is exposed root surface or a tooth getting long. The main indication for root coverage procedures are esthetics and/or cosmetic demands followed by the management of root hypersensitivity, root caries or when it hampers proper plaque removal. Over the years, various techniques have been used to achieve root coverage.Aim and Objectives:The aim of this study was to compare the effectiveness of subpedicle acellular dermal matrix allograft (ADMA) with subepithelial connective tissue graft (SCTG) in the treatment of isolated marginal tissue recession.Materials and Methods:Twenty systemically healthy patients aged between 18 to 50 years (mean age29.7±4.35 years) with a recession defect on the labial and the buccal surfaces of any teeth were selected for the study. Ten patients received the test treatment (ADMA), ten patients received the control treatment (SCTG). Clinical recordings assessed at baseline, three months and six months post surgery, included Plaque index (PI), Papillary bleeding index (PBI), Gingival recession (REC), Probing pocket depth (PPD), Clinical attachment level (CAL) and Width of keratinized gingival (WKG).Results:Test group (ADMA) showed 86.93% mean root coverage while control group (SCTG) showed 84.72% at six months post surgery. Mean increase in the width of keratinized gingiva was significantly greater in the SCTG group (3.3±0.48mm) compared to ADMA group (2.4±0.51mm). Conclusion: Both the treatment produced a significant reduction in gingival recession and probing pocket depth and significant gain in clinical attachment level and width of keratinised gingiva.

Root Coverage Using the Subepithelial Connective Tissue Graft or the Acellular Dermal Matrix for the Treatment of Gingival Recession: A Clinical Study

“…These findings are in accordance with previous studies by Shori et al and Guan et al [7,12]. SCTG has been known to provide the best rootcoverage outcomes; its predictability is as high as 95% for Miller's Class I and II cases [13,14].…”

“…This technique offers higher levels of root coverage than other techniques due to the dual blood supply is given to the graft; better esthetics and good postoperative healing at the donor site are other benefits [5,6]. SCTG has also been found to increase the width of keratinized gingiva significantly [7]. However, the graft needs to be harvested from the palate, meaning that the technique demands an intricate second surgical procedure, which adds to patient morbidity levels and surgical chair time [3].…”

Root coverage procedures for treating single and multiple recession‐type defects: An updated Cochrane systematic review

“…Forty‐eight studies (reported in 57 papers) were included in the review, with 20 providing data for meta‐analyses. Nine RCTs had their data reported in two articles each (i.e., according to the follow‐up period or type of data (i.e., clinical or patient‐reported outcomes) .…”

Periodontal Soft Tissue Root Coverage Procedures: A Systematic Review From the AAP Regeneration Workshop

“…A total of 101 articles 30‐131 with 94 RCTs potentially eligible for inclusion into the pooled estimates were identified in the base of evidence, and their main characteristics (i.e., number and age of participants, interventions, follow‐up period, number of sites exhibiting CRC, MRC [percentage], use of RMAs, randomization, allocation concealment, masking of examiners, completeness of the follow‐up period, and risk of bias) are depicted in Table 2 30‐131 . Seven studies were reported in two articles each, and their data were reported under one study name 37,38,57,58,65,66,83,84,90,91,110,111,115,116 …”

“…Of the 94 trials included in Table 2, 52 were included in the following sets of meta‐analyses: 1) ADMG/CM + CAF versus SCTG‐based procedures; 31,66,76,97,102,114 2) ADMG/CM + CAF versus CAF; 57,58,86,125 3) BS + GTR with resorbable membranes (RS) + CAF versus GTR with RS + CAF; 62,63,78,101 4) EMD + CAF versus CAF; 51,53,59,71,94,103,115,116 5) EMD + CAF versus SCTG + CAF; 30,32,90,91 6) GTR with RS + CAF versus CAF; 36,83,84 7) GTR (all types of membrane) + CAF versus SCTG‐based procedures; 35,43,55,74,96,101,107,109,117,122,123,126 8) SCTG‐based procedures versus CAF; 40,41,54,56,80 9) SCTG + CAF versus SCTG (epithelial collar); 44,47 10) SCTG‐based procedures, micro versus macro procedures; 42,46 and 11) SCTG‐based procedures versus FGG 70,100 . All of the comparisons were performed using studies reporting data on single defects, except for one comparison on EMD + CAF versus CAF 53,71 that could also be conducted using data on multiple recessions.…”