Coronally advanced flap in combination with acellular dermal matrix with or without enamel matrix derivatives for root coverage

Abstract

Background: Coverage of gingival recession defects has been considered as a subject of interest for dental practitioners. Aim: The present study was aimed to compare the clinical outcomes of root coverage (RC) procedures, using coronally advanced flap (CAF) in combination with acellular dermal matrix (ADM) with or without enamel matrix derivatives (EMD). Materials and Methods: A total of 36 Miller class I or II recession defects in 15 eligible patients were selected. The defects were randomly allocated to test (CAF+ADM+EMD) and control (CAF+ADM) groups. Recession depth (RD), recession width (RW), width of keratinized tissue (WKT), clinical attachment level (CAL), and the position of mucogingival junction (MGJ) were measured at baseline, two and six months after treatment. Statistical Analysis: Data were analyzed using repeated measures ANOVA and paired sample t-test with the patients as statistical unit. Results: At two-month follow-up, the mean RC for CAF+ADM+EMD and CAF+ADM was 82.75 ± 22 and 88.89 ± 22 percent, respectively. However, these values did not change significantly after six months. Both treatments led to significant RC (P < 0.001), whereas no significant differences were observed in WKT, CAL, and MGJ between the study groups. Conclusion: The application of EMD does not improve the clinical efficacy of ADM in combination with CAF in RC procedures.

Keywords

• Acellular dermal matrix
• coronally advanced flap
• gingival recession
• enamel matrix protein
• root coverage