Clinical outcomes of root coverage using porcine-derived collagen matrix with modified coronally advanced tunnel technique (MCAT) in multiple gingival recessions in smokers — a randomized controlled clinical trial

Abstract

OBJECTIVES: Root coverage(RC)is an integral part in management of gingival recessions. Unlike isolated recessions, treating multiple recessions is the most challenging scenario especially in smokers who have reported reduced RC in terms of quantity and stability. Modi ed coronally advanced tunnel(MCAT) technique due to its improved vascularity along with use of porcine-derived collagen matrix (PDCM) (Mucograft™) with its bilayered dense collagen matrix may be a predictable alternative to conventional gold standard subepithelial connective tissue graft(SCTG). The purpose of this study was to compare the results of RC achieved using PDCM and SCTG with the MCAT approach in the treatment of multiple gingival recessions in smokers.METHODOLOGY: This is a prospective randomized controlled clinical study registered under clinical trial registry (CTRI no. CTRI/2020/03/024238) including 28 patients with 64 recession defects. Patients were randomized into SCTG and PDCM groups which were treated with SCTG using MCAT and PDCM using MCAT technique respectively. Recession depth(RD), Recession width(RW), Width of keratinized tissue(WKT), Thickness of keratinized gingiva(TKG), %RC, were assessed at baseline,3,6 months. Complete RC(CRC) at 3 and 6 months, RC esthetic scores(RCES) at 6 months. RESULTS: Both groups showed signi cant improvement in all clinical parameters. Intergroup comparison showed better performance of PDCM group in terms of RD,%RC,TKG,WKT,CRC(45.06%),RCES (p<0.001) compared to SCTG group. Time taken for surgical procedure and Visual Analog pain scores were signi cantly lesser in PDCM group. CONCLUSION: PDCM showed good predictable results in terms of all RC parameters compared to SCTG and thus may be used as a predictable alternative to SCTG for RC in smokers.

&lt;i&gt;In Vitro&lt;/i&gt; Evaluation of Two Tissue Substitutes for Gingival Augmentation

“…The results of the study indicate an increase in MMP-2 and TIMP-1 and TIMP-2 on cells plated on Fibro-Gide®, possibly indicating a greater ability of this matrix to stimulate periodontal and peri-implant tissue remodeling when compared with Mucoderm®. However, it's important to state that Mucoderm® can be considered an alternative to autogenous connective tissue graft for root coverage purposes [35]. Further in vivo studies using both matrices are required to determine whether the Fibro-Gide® matrix is in fact capable of promoting tissue remodeling in a beneficial way in terms of clinical results, or whether it induces more intense inflammation during healing.…”