Subepithelial connective tissue graft with or without enamel matrix derivative for the treatment of <scp>M</scp>iller class <scp>I</scp> and <scp>II</scp> gingival recessions: a controlled randomized clinical trial

Roman, Alexandra; Şoancă, Andrada; Kašaj, Adrian; Stratul, Ştefan‐Ioan

doi:10.1111/jre.12039

Cited by 43 publications

(72 citation statements)

References 47 publications

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“…Individual patient data (IPD) were provided by the author and re‐analysed to obtain mean difference for VAS Est. Roman et al. () considered the comparison between CAF + CTG + Enamel matrix Derivatives (EMD) versus CAF + CTG. The mean VAS Est was 87.0 ± 16 for the test group while 89.5 ± 15 for the control group.…”

Section: Results Of the Analysismentioning

confidence: 99%

Root coverage procedures improve patient aesthetics. A systematic review and Bayesian network meta‐analysis

Cairo

Pagliaro²,

Buti

et al. 2016

J Clinic Periodontology

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Background: The aim of this study was to perform a systematic review (SR) of randomized controlled trials (RCTs) to explore if periodontal plastic surgery procedures for the treatment of single and multiple gingival recessions (Rec) may improve aesthetics at patient and professional levels. Material and Methods:In order to combine evidence from direct and indirect comparisons by different trials a Bayesian network meta-analysis (BNM) was planned. A literature search on PubMed, Cochrane libraries, EMBASE, and hand-searched journals until January 2015 was conducted to identify RCTs presenting aesthetic outcomes after root coverage using standardized evaluations at patient and professional level.Results: A total of 16 RCTs were selected in the SR; 3 RTCs presenting professional aesthetic evaluation with Root coverage Aesthetic Score (RES) and 3 showing final self-perception using the Visual Analogue Scale (VAS Est) could be included in a BNM model. Coronally Advanced Flap plus Connective Tissue Graft (CAF+CTG) and CAF+Acellular Dermal Matrix (ADM) and Autologous Fibroblasts (AF) were associated with the best RES outcomes (best probability = 24% and 64%, respectively), while CAF+CTG and CAF+CTG+Enamel matrix Derivatives (EMD) obtained highest values of VAS Est score (best probability = 44% and 26%, respectively). Conclusions: Periodontal Plastic Surgery (PPS) techniques applying grafts underneath CAF with orwithout the adding of EMD are associated with improved aesthetics assessed by final patient perception and RES as professional evaluation system. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 To compare, using a Bayesian network meta-analysis, the efficacy of periodontal plastic surgery procedures to improve aesthetics as assessed by professional and patient scores. Principal findings:Coronally Advanced Flap plus Connective Tissue Graft (CAF+CTG) and CAF plus Acellular Dermal Matrix (ADM) and Autologous Fibroblasts (AF) were associated with the highest professional outcomes rated by means of Root Coverage Aesthetics Score (RES). CAF+CTG and CAF+CTG plus Enamel Matrix Derivatives (EMD) obtained highest values in term of patient satisfaction rated by Visual Analogue Scale (VAS est). Practical implications:Grafting underneath the Coronally Advanced Flap with or without the adding of Enamel Matrix Derivatives is associated with highest aesthetic outcomes at professional and patient level. Conflict of Interest:The authors certify that there is no conflict of interest concerning the contents of the study. Source of Funding:The study was self founded by authors. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 INTRODUCTIONAesthetic concern is a primary in...

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Section: Results Of the Analysismentioning

confidence: 99%

Root coverage procedures improve patient aesthetics. A systematic review and Bayesian network meta‐analysis

Cairo

Pagliaro²,

Buti

et al. 2016

J Clinic Periodontology

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“…Sample size calculation for this superiority trial was performed considering root coverage as the primary outcome. The study was powered to detect a significant difference in root recession reduction among four groups ( F test–analysis of variance [ANOVA] for repeated measurements: α = 0.05, power = 80%, effect size = 0.443), based on data from previous studies to calculate the effect size 8,19,20 . A total sample of 60 patients was required in the present trial.…”

Section: Methodsmentioning

confidence: 99%

Xenogenous Collagen Matrix and/or Enamel Matrix Derivative for Treatment of Localized Gingival Recessions: A Randomized Clinical Trial. Part I: Clinical Outcomes

Sangiorgio

Neves

Santos

et al. 2017

Journal of Periodontology

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“…The consensus is that the supplementary use of EMD in root coverage procedures led to improved keratinized tissue and stability of the increased gingival margin level . However, the majority of these clinical studies are of short duration (6‐18 months), with sample sizes limited to no more than 60 teeth . Additionally, the few available longer term studies have shown inconsistent results.…”

Section: Introductionmentioning

confidence: 99%

A 3‐year prospective clinical and patient‐centered trial on subepithelial connective tissue graft with or without enamel matrix derivative in Class I‐II Miller recessions

Mercado

Hamlet

Ivanovski

2019

J of Periodontal Research

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Background and Objective The study compared clinical and patient‐centered outcomes of subepithelial connective tissue graft (CTG) with and without enamel matrix derivative (EMD) in the treatment of Class I‐II Miller periodontal recession defects. Material and Methods This prospective clinical study evaluated 80 patients over a 3 years follow‐up in a private periodontal practice. A total of 144 maxillary and mandibular anterior teeth were divided into two groups: group 1 (CTG with EMD—80 teeth) and group 2 (CTG only—64 teeth). Recession (REC), keratinized tissue (KT) width, % root overage, patient‐centered outcomes, and pain visual analog scale (P‐VAS) were compared between the two groups. Results At 3 years follow‐up at a patient level, statistically significant changes in REC were achieved in both group 1 (4.65 ± 1.84 to 0.39 ± 0.19 mm) and group 2 (4.43 ± 1.11 to 0.92 ± 0.43 mm). Complete root coverage (CRC) was achieved in 66.4% of group 1 and 50.1% of group 2. At both patient and tooth level, the 3‐year outcomes were superior for group 1 compared with group 2 in terms of % root coverage, REC, and KT width. Clinical attachment loss (CAL) was reduced in group 1 compared with group 2 at the tooth level analysis only (<.01). Significantly less pain was reported using the pain visual analog Scale (P < .001) at the two weeks follow‐up post‐surgery in group 1. Conclusions Addition of EMD results in improved root coverage outcomes and higher amounts of keratinized tissue width 36 months after treatment of multiple adjacent recessions on maxillary and mandibular anterior teeth. The adjunctive use of EMD also resulted in significantly reduced pain 14 days after the surgery.

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Subepithelial connective tissue graft with or without enamel matrix derivative for the treatment of Miller class I and II gingival recessions: a controlled randomized clinical trial

Abstract: The present study failed to demonstrate any additional clinical benefits when EMD was added to SCTG plus CAF.

Cited by 43 publications

References 47 publications

Root coverage procedures improve patient aesthetics. A systematic review and Bayesian network meta‐analysis

Root coverage procedures improve patient aesthetics. A systematic review and Bayesian network meta‐analysis

Xenogenous Collagen Matrix and/or Enamel Matrix Derivative for Treatment of Localized Gingival Recessions: A Randomized Clinical Trial. Part I: Clinical Outcomes

A 3‐year prospective clinical and patient‐centered trial on subepithelial connective tissue graft with or without enamel matrix derivative in Class I‐II Miller recessions

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