Efficacy of Human Chorion Membrane Allograft for Recession Coverage: A Case Series

Abstract

Background: Membranes of human placentas have been used in the field of medicine for skin grafts, treatment of burns, and ulcerated skin conditions with great success. The use of placenta allografts in dentistry is a more recent development, with the first commercial product being made available in 2008. The unique inherent biologic properties in placenta allografts enhance wound healing and may propagate regeneration.Methods: Ten healthy adult patients presenting with 21 Miller Class I gingival recession (GR) defects (isolated or adjacent multiple) were surgically treated with a modified coronally advanced flap and chorion membrane for root coverage. Clinical parameters measured at baseline, 3 months, and 6 months were probing depth, clinical attachment level, GR height, width of keratinized gingiva, and assessment of gingival biotype. Statistical analysis was performed to compare the treatment outcomes at the follow‐up intervals.Results: The results showed statistically significant (P <0.001) improvements in all clinical parameters at the 3‐ and 6‐month follow‐ups. The mean percentage of root coverage at the end of 6 months was 89.92% ± 15.59%, and 14 of 21 treated GR defects showed 100% root coverage. The gingival biotype also showed a thick biotype in nine sites that had an initial thin biotype.Conclusions: Fetal membranes possess distinctive properties that can be harnessed to promote periodontal healing. The chorion membrane covered by a modified coronally advanced flap is a new approach that has shown promising results in terms of root coverage, increased width of keratinized tissue, and thickness of the gingival biotype.

Treatment of gingival recession using a coronally‐advanced flap procedure with or without placental membrane

“…This was in accordance Esteves et al. 's study, where there was reduction of HGR from 3.14 ± 1.24 to 2.76 ± 1.00 when placental membranes were used for the treatment of recession defects. The significant reduction in HGR could be due to the presence of growth factors in placental membranes that aid in the formation of granulation tissue by stimulating fibroblast growth and neovascularization, as seen in Koizumi et al.…”

Comparative evaluation of clinical efficacy of coronally advanced flap alone and in combination with placental membrane and demineralized freeze-dried bone allograft in the treatment of gingival recession

“…Gingival index (GI)[12]GR depth (GRD) calculated from the cementoenamel junction (CEJ) to the free gingival margin at the center of facial surface[913]GR width (GRW) calculated across the labial surface and at CEJ[913]Relative attachment level (RAL) measured midlabially with the reference point situated at the buccal cusp/incisal edge[91314]Complete or partial root coverage[91314] estimated using the following formula:Width of keratinized tissue (KTW) measured from the gingival margin to the mucogingival junction (MGJ), at the mid-buccal point. The MGJ was noted by means of Schiller's iodine.…”

Root Coverage Procedures for Multiple Recession Defects

“…At 6 months, the authors reported mean root NSD no significant difference, SCTG subepithelial connective tissue graft, Pts/Def-T patient/defect numbers in the test group, Pts/Def-C patient/defect numbers in the control group, mean RC-T mean root coverage in the test group, mean RC-C mean root coverage in the control group, CPF coronally positioned flap, ADM acellular dermal matrix allograft (AlloDerm®), CM porcine collagen matrix (Mucograft®), EMD enamel matrix derivative (Emdogain®), LPRF leukocyte-and platelet-rich fibrin, rhPDGF-BB recombinant human platelet-derived growth factor BB, β-TCP β-tricalcium phosphate, AFCC autologous fibroblast cell culture, UC-MSC umbilical cord-mesenchymal stem cell, LLLT low-level laser therapy coverage of 87%, along with increased gingival thickness and width of keratinized tissue. Human chorion membrane was tested on isolated/multiple gingival recession defects (21 defects in 10 subjects) in a case series report [55]. The mean root coverage was 90% at 6 months, and all sites with an originally thin biotype were converted to a thick biotype.…”