Comparison of Coronally Advanced Root Coverage Procedure With Collagen Matrix and Connective Tissue Graft
Condition: Gingival Recession
MeSH terms: Gingival Recession
Study type: Interventional

Summary: 
      The present study is a human, prospective, randomised controlled clinical trial conducted to
      explore the outcome of a coronally advanced flap with ossix volumaxTM collagen matrix and
      connective tissue graft in the treatment of multiple adjacent gingival recession defects.

      The trial is in accordance with the Consolidated Standards of Reporting Trials (CONSORT)
      criteria, 2010.
    

Detailed description: 
      Periodontal plastic surgery are surgical procedures performed to prevent or correct anatomic,
      developmental, traumatic or disease-induced defects of the gingiva, alveolar mucosa or bone.
      It includes various soft and hard tissue procedures aimed at gingival augmentation, root
      coverage, correction of mucosal defects at implants, crown lengthening, gingival preservation
      at ectopic tooth eruption, removal of aberrant frena, prevention of ridge collapse associated
      with tooth extraction and augmentation of the edentulous ridge.1

      Different predisposing anatomic features can result in recession such as position and anatomy
      of teeth in the dental arch, bony dehiscence, thickness of the alveolar mucosa, muscle pull,
      orthodontic treatment, thin gingival biotype, buccal prominence of teeth, lack of keratinized
      tissue, abnormal frenum attachment, or patient related factors such as vigorous brushing or
      chronic gingival inflammation.2 The migration of the marginal tissue to an apical position
      may lead to esthetic concern, dentin hypersensitivity, root caries, and cervical wear.
      Treatment modalities for gingival recession have many influencing factors such as defect
      dimensions (depth, width), site (maxilla, mandible), defect number (single, multiple), soft
      tissue anatomy (keratinized tissue quality/quantity; papilla height/width; frenum/ muscle
      pull; vestibular depth) tooth position etc.

      Various surgical techniques for the treatment of recessions includes the use of full or
      partial thickness flap with various soft tissue grafts such as epithelized free gingival
      grafts (FGG) or sub-epithelial connective tissue graft (SCTG) in conjunction with various
      types of flaps eg: (envelope, coronally or laterally positioned flap, double pedicle flap
      (DPF) or tunnelling (TUN) alone or combined with laterally positioned pedicle flaps (LPPF).3
      Coronally advanced flap (CAF) with connective tissue graft (CTG) is considered as the gold
      standard treatment for gingival recession. Commercially available materials for root coverage
      are expanded Poly Tetra Fluoro Ethylene (Gore-Tex), polglactin, Collagen membranes like
      biogide, biomend, resolute, alloderm, collatape etc, collagen matrix such as mucograft, human
      amniotic membrane, dermagraft, ossix.4

      Recently in a case report using platelet concentrate carried on collagen sponge (ossix)
      showed favourable results.4 Ossix volumax™ has shown De novo bone formation when used in
      alveolar ridge augmentation procedure.5

      Ossix volumax™ (Datum dental) is one such recently identified sugar cross-linked bio
      programmed collagen matrix. Ossix volumax™ is a volumizing, thick collagen scaffold,
      featuring glymatrix technology. The properties are thick and expand when wet, excellent
      handling, easy to use, adapts and adheres to the bone.5 It undergoes rapid ossification (in
      CT scans and histology after one month).6

      Literature search till date has shown no studies regarding the use of type 1 sugar
      cross-linked collagen membrane for treatment of gingival recession. So, the present study is
      undertaken with the aim to comparatively evaluate the advantages of ossix volumax collagen
      membrane with subepithelial connective tissue graft for the treatment of multiple adjacent
      gingival recession defects.
    

Intervention name(s): Ossix volumax collagen matrix; Connective Tissue Graft
Intervention type(s): Procedure; Procedure
Intervention description(s): Under LA horizontal incision is made.Split-full-split thickness flap is elevated.The remaining soft tissue of the anatomic interdental papillae deepithelialized.Coronal advancement of the flap obtained and closed using sling suture.; Under LA parallel incisions is made 1-2 mm first molar to canine.Graft incision 1 mm coronal to the horizontal flap incision.Through this incision designed graft thickness is obtained.The graft obtained between the two horizontal incisions has a 1 mm coronal strip that require depithelisation with a knife and closed using interrupted suture.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Two groups were made one test and control. The test group will be treated with coronally advanced flap with ossix volumax™ collagen matrix and control group will be treated with coronally advanced flap with Sub epitheial Connective Tissue Graft.
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Gingival Recession Coverage