Novel Porcine Dermal Matrix in the Treatment of Multiple Adjacent Gingival Recessions
Condition: Recession, Gingival
MeSH terms: Gingival Recession
Study type: Interventional

Summary: 
      The aim of this study was to assess the clinical efficacy of the acellular porcine derived
      collagen matrix (PADM) in comparison with connective tissue graft (SCTG ) in the treatment of
      multiple adjacent gingival recessions (MAGR). The primary objectives of the study were to
      evaluate mean and complete roots coverage. Additionally, the secondary objective was to
      evaluate and compare the clinical effectiveness of PADM and SCTG for the treatment of MAGR
      defects applying modified coronally advanced tunnel technique (MCAT).
    

Detailed description: 
      Treatment of multiple adjacent gingival recessions (MAGR) still presents a challenge for the
      clinician. The management of soft tissues becomes more complicated and the wound healing may
      be compromised by a variety of factors.

      According to the available medical databases, predictable root coverage is possible for
      multiple-tooth recession defects using subepithelial connective tissue graft (SCTG)
      procedures. However, alternative materials to SCTG are supported by evidence of varying
      strength, with the need for additional research to confirm their performance and success
      rate. Because of that, the aim of this study was to assess the clinical efficacy of the
      acellular porcine derived collagen matrix (PADM) in comparison with connective tissue graft
      (SCTG ) in the treatment of multiple adjacent gingival recessions (MAGR).

      This study is a randomised controlled clinical trial of 12 months duration. Sixteen patients
      with a total of 81 MAGR Miller's Class I or II were enrolled in this study. Recessions were
      randomly treated with PADM and SCTG, combined with a modified coronally advanced tunnel
      technique (MCAT). Several parameters, such as gingival recession coverage (RC), keratinized
      tissue width (KTW), keratinized tissue thickness (KTT) and clinical attachment level (CAL)
      were recorded at baseline and one year postoperatively. Healing index (HI) was registered on
      1st, 2nd, and 3rd-week post-surgery in order to estimate healing events.
    

Intervention name(s): Surgery 1; Surgery 2
Intervention type(s): Procedure; Procedure
Intervention description(s): Following local anaesthesia (Articaine hydrochloride 4% with 1:200,000 epinephrine injection) administration, sulcular incisions were made in the recession's areas of teeth without damaging interdental papilla. Mucoperiosteal (MP) dissections were made using the periostal elevator creating the deep pouch beyond the mucogingival junction so that the (MP) flap could be moved coronally without tension. Porcine-derived acellular dermal collagen matrix (PADM) was positioned at the level of a cemento-enamel junction (CEJ) and skin tight for teeth to avoid forming a blood clot. Separate single sutures per tooth with 5-0 resorbable suture were used to stabilise graft. The tunnel flap was positioned coronally above the CEJ to completely cover the graft and sutured with non-resorbable polypropylene suture.; Following local anaesthesia (Articaine hydrochloride 4% with 1:200,000 epinephrine injection) administration, sulcular incisions were made in the recession's areas of teeth without damaging interdental papilla. Mucoperiosteal (MP) dissections were made using the periostal elevator creating the deep pouch beyond the mucogingival junction so that the (MP) flap could be moved coronally without tension. Connective tissue graft was positioned at the level of a cemento-enamel junction (CEJ) and skin tight for teeth to avoid forming a blood clot. Separate single sutures per tooth with 5-0 resorbable suture were used to stabilise graft. The tunnel flap was positioned coronally above the CEJ to completely cover the graft and sutured with non-resorbable polypropylene suture.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: multiple gingival recessions; collagen matrix; connective tissue graft; tunnel technique