Journal of International Clinical Dental Research Organization (Jan 2022)

Comparative evaluation of root coverage with amniotic membrane under macrosurgical and microsurgical approach: A prospective clinical trial

  • L Princee Mani,
  • P S Gautami,
  • N V SG Sruthima,
  • K S V Ramesh,
  • Vivek Bypalli,
  • K Radha Rani

DOI
https://doi.org/10.4103/jicdro.jicdro_75_21
Journal volume & issue
Vol. 14, no. 2
pp. 126 – 134

Abstract

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Objectives: Gingival recession is a major concern as it causes unesthetic appearance during smiling, dentinal hypersensitivity, and root caries. Several surgical procedures have been undertaken to cover these exposed root surfaces, with the most predictable and effective being coronally advanced flap (CAF) with subepithelial connective tissue graft. Because amniotic membrane (AM) contains embryonic stem cells, it can be utilized as a possible autograft/periodontal-guided tissue regeneration substitute. Magnification improves visibility and causes less tissue trauma during surgery. Therefore, the goal of this study was to evaluate the efficacy of root coverage with AM utilizing a conventional macrosurgical technique (MaT) versus microsurgical technique (MiT) employing loupes. Materials and Methods: This randomized clinical trial included 24 patients, 12 of whom were treated using MaT and 12 utilizing MiT with 4x magnification loupes. Clinical parameters such as amount of root coverage in terms of vertical gingival recession (VGR), horizontal gingival recession (HGR), increase in width of keratinized gingiva (WKG), clinical attachment loss, and patient satisfaction analysis for the evaluation of discomfort, dentinal hypersensitivity, and esthetics were recorded at baseline and 3 and 6 months after surgery. Results: Both the groups demonstrated improvement in all clinical parameters. However, the test group showed a significant reduction in VGR and HGR with a mean difference of 0.95 mm (P = 0.007) and 2.167 mm (P = 0.002) at 6 months, respectively. There was no significant difference in the mean WKG and hypersensitivity scores between the two groups. Conclusion: Both treatment approaches, i.e., MaT and MiT with the use of AM, were effective in improving the clinical parameters and the amount of root coverage. However, the test group showed a better reduction in discomfort and hypersensitivity postoperatively with enhanced esthetic outcomes. Clinical Relevance: Magnification-assisted root coverage attained predictable outcome.

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