Tunnel technique with enamel matrix derivative in addition to subepithelial connective tissue graft compared with connective tissue graft alone for the treatment of multiple gingival recessions: a randomized clinical trial.

Bartłomiej Górski, Renata Górska, Joanna Wysokińska-Miszczuk, Tomasz Kaczyński
Author Information
  1. Bartłomiej Górski: Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw, S. Binieckiego 6 St, 02-097, Warsaw, Poland. bartek_g3@tlen.pl. ORCID
  2. Renata Górska: Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw, S. Binieckiego 6 St, 02-097, Warsaw, Poland.
  3. Joanna Wysokińska-Miszczuk: The Chair and Department of Periodontology, Medical University of Lublin, Karmelicka 7 St, 20-081, Lublin, Poland.
  4. Tomasz Kaczyński: Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw, S. Binieckiego 6 St, 02-097, Warsaw, Poland.

Abstract

OBJECTIVES: The aim of this study was to compare outcomes of the modified coronally advanced tunnel technique (MCAT) combined with subepithelial connective tissue graft (SCTG) with or without enamel matrix derivative (EMD), in the treatment of gingival recession types 1 and 2.
MATERIALS AND METHODS: A total of 20 patients with 150 multiple gingival recessions (GR) were included in the study. On one side, MCAT was combined with SCTG and EMD (tests), whereas MCAT with SCTG was applied on the contralateral side (controls). Clinical parameters were measured at baseline and 6 months after surgery. Visual analog scales (VAS) and questionnaires were used to assess patient-reported outcomes and the root coverage esthetic score (RES) for professional esthetic evaluation.
RESULTS: MCAT+SCTG+EMD was not superior with regard to root coverage. At 6 months, average root coverage (ARC) was 87.4% for SCTG+EMD-treated and 90.9% for SCTG-treated defects (p = 0.4170). Complete root coverage (CRC) was observed in 86.7% (tests) and 85.3% (controls) of the cases (p = 0.9872). Significantly less pain was reported using VAS (p = 0.0342) post-operatively in the SCTG+EMD group. Professional assessment of esthetic outcomes using RES showed a significant difference (9.25 versus 8.71, p = 0.0103) in favor of the test group.
CONCLUSIONS: Both treatment modalities were equally effective in treatment of multiple GR and led to similar improvements in clinical parameters. However, the application of EMD as an adjunct resulted in less post-operative pain and better professionally assessed esthetic outcomes.
CLINICAL RELEVANCE: Patients' early morbidity and 6-month esthetic outcomes following GR coverage with MCAT might be influenced by means of EMD utilization.

Keywords

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MeSH Term

Connective Tissue
Esthetics, Dental
Gingiva
Gingival Recession
Humans
Surgical Flaps
Tooth Root
Treatment Outcome

Word Cloud

Created with Highcharts 10.0.0outcomescoverageestheticMCATconnectivetissuegraftEMDtreatmentgingivalrootp = 0techniqueSCTGmatrixderivativemultipleGRstudycoronallyadvancedtunnelcombinedsubepithelialenamelrecessionssidetestscontrolsparameters6 monthsVASRESlesspainusinggroupclinicalOBJECTIVES:aimcomparemodifiedwithoutrecessiontypes12MATERIALSANDMETHODS:total20patients150includedonewhereasappliedcontralateralClinicalmeasuredbaselinesurgeryVisualanalogscalesquestionnairesusedassesspatient-reportedscoreprofessionalevaluationRESULTS:MCAT+SCTG+EMDsuperiorregardaverageARC874%SCTG+EMD-treated909%SCTG-treateddefects4170CompleteCRCobserved867%853%cases9872Significantlyreported0342post-operativelySCTG+EMDProfessionalassessmentshowedsignificantdifference925versus8710103favortestCONCLUSIONS:modalitiesequallyeffectiveledsimilarimprovementsHoweverapplicationadjunctresultedpost-operativebetterprofessionallyassessedCLINICALRELEVANCE:Patients'earlymorbidity6-monthfollowingmightinfluencedmeansutilizationTunneladditioncomparedalonerecessions:randomizedtrialEnamelEstheticsModifiedMultipleSubepithelial

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