Does enamel matrix derivative application improve clinical outcomes after semilunar flap surgery? A randomized clinical trial.
Isabela Lima França-Grohmann, João Paulo Menck Sangiorgio, Manuela Rocha Bueno, Renato Corrêa Viana Casarin, Karina Gonzáles Silvério, Francisco Humberto Nociti, Márcio Zaffalon Casati, Enilson Antonio Sallum
Author Information
Isabela Lima França-Grohmann: Department of Prosthodontics and Periodontics, Division of Periodontics - Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil. isalf.perio@gmail.com. ORCID
João Paulo Menck Sangiorgio: Department of Prosthodontics and Periodontics, Division of Periodontics - Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
Manuela Rocha Bueno: Department of Prosthodontics and Periodontics, Division of Periodontics - Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
Renato Corrêa Viana Casarin: Department of Prosthodontics and Periodontics, Division of Periodontics - Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
Karina Gonzáles Silvério: Department of Prosthodontics and Periodontics, Division of Periodontics - Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
Francisco Humberto Nociti: Department of Prosthodontics and Periodontics, Division of Periodontics - Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
Márcio Zaffalon Casati: Department of Prosthodontics and Periodontics, Division of Periodontics - Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
Enilson Antonio Sallum: Department of Prosthodontics and Periodontics, Division of Periodontics - Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
OBJECTIVES: To evaluate the treatment of gingival recessions by semilunar coronally positioned flap plus enamel matrix derivative (SCPF + EMD). MATERIALS AND METHODS: Thirty patients with class I localized gingival recession were included. They were randomly allocated in two groups: SCPF + EMD and SCPF. Recession height (RH), recession width (RW), width of keratinized tissue (WKT), thickness of keratinized tissue (TKT), probing depth (PD), and clinical attachment level (CAL) were measured at baseline, 6 and 12 months post-surgery. Patient/professional evaluation of esthetics and root sensitivity was performed. RESULTS: After 12 months, mean root coverage was 1.98 ± 0.33 mm for SCPF + EMD (90.86 ± 14.69%) and 1.85 ± 0.41 mm (79.76 ± 17.44%) for SCPF (p > 0.05). The esthetic evaluation by the patient showed preference for SCPF + EMD. According to the professional evaluation (QCE), the use of EMD decreases the appearance of postoperative scar tissue line. There was a significant reduction in root hypersensitivity with no further complaints by the patients. CONCLUSIONS: The addition of EMD provides significantly better esthetics to SCPF, according to patient and professional assessments. SCPF + EMD is effective but not superior to SCPF for root coverage, after 12 months. CLINICAL RELEVANCE: Previous clinical trials showed that the combination of EMD with coronally advanced flaps may enhance the outcome of root coverage. There is a lack of studies testing the combination of EMD with SCPF. The combination SCPF + EMD provides better esthetics when compared to the SCPF and is effective, but not superior, to SCPF for root coverage, after 12 months. TRIAL REGISTRATION: NCT02459704.
