Evaluation of Two Types of Matrix (Mucograft® and Mucoderm®) Associated With Coronally Advanced Flap
Condition: Gingival Recession
MeSH terms: Gingival Recession
Study type: Interventional

Summary: 
      The aim of this study is to evaluate clinically the results of two types of matrix (Geistlich
      Mucograft® and Mucoderm®) associated with CAF technique for the treatment of gingival
      recessions.
    

Detailed description: 
      This is a prospective, parallel and controlled clinical trial. The population that will be
      evaluated in the study will be selected at Institute of Science and Technology (ICT), São
      José dos Campos, College of Dentistry.

      Seventy-five patients presenting gingival recession will be divided in 3 groups:

        -  Group CAF + XDM (25): Periodontal surgery for root coverage through coronally advanced
           flap technique plus xenogenous dermal matrix graft Mucoderm®.

        -  Group CAF + MC (25): Periodontal surgery for root coverage through coronally advanced
           flap technique plus xenogenous collagen matrix graft Mucograft®.

        -  Group CAF (25): Periodontal surgery for root coverage through coronally advanced flap
           alone.

      All surgeries will be performed by a single operator (MPS) at the dental clinic of ICT. Two
      horizontal incisions will be made at right angles to the adjacent interdental papillae,
      without interfering with gingival margins of neighboring teeth. Two oblique vertical
      incisions will be extended beyond the mucogingival junction and a trapezoidal mucoperiosteal
      flap will be raised up to the mucogingival junction. After, a split-thickness flap will be
      extended apically, releasing the tension and favoring coronal positioning of the flap. The
      exposed root surface will be scaled and planed. After the root planning procedures are
      performed, the epithelial layer from incised papillae will be removed to expose the
      connective tissue. After this, the group in which the participant is inserted will be
      revealed to the surgeon. The grafts will be used according to the producers' instructions. In
      the CAF + MD group, the matrix will be placed without previous hydration with saline
      solution, whereas in the CAF + XDM group the matrix will be hydrated with sterile saline for
      10 minutes. In both grafts groups, the matrix will be cut into the desired dimensions to
      cover the entire surface of the root and around the bone, being positioned at the CEJ level.
      The matrix will be sutured independently of the flap, with the porous surface in contact with
      the tooth and bone, while the smooth surface will be facing the flap. Then, the flap will be
      coronally positioned and sutured to completely cover the graft. After the surgical procedure,
      the patients will receive the appropriate postoperative recommendations and sutures will be
      removed after 10 to 14 days of the surgical procedure.

      Clinical parameters will be assessed at baseline and 3 and 6 months postoperatively.

      Quantitative data were recorded as mean ± standard deviation (SD), and normality was tested
      using Shapiro-Wilk tests. The probing depth (PD), relative gingival recession (RGR), clinical
      attachment level (CAL), keratinized tissue thickness (KTT), keratinized tissue width (KTW),
      aesthetic (A), postoperative discomfort (PD), dentin hypersensitivity (DH) and tissue edema
      (TE) values will be examined variance test. Patients' esthetics and discomfort measures using
      a visual analog scale (VAS) will be analyzed by T-tests. The frequency of complete root
      coverage will be compared using χ2 tests. Intergroup root coverage esthetic score (RES)
      comparisons will be performed with a T-test.
    

Intervention name(s): CAF; MC; XDM
Intervention type(s): Procedure; Other; Other
Intervention description(s): Periodontal surgical technique to treat gingival recessions.; Xenogenous graft placed in the surgical site.; Xenogenous dermal collagen graft placed in the surgical site.
Other intervention name(s): Periodontal plastic surgery; Xenogenous collagen matrix graft (Mucograft®); Xenogenous dermal collagen matrix graft (Mucoderm®)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment