Acellular dermal matrix and gingival connective in the treatment of periodontal recessions – comparative clinical evaluation in humans

Mauricio Augusto Aquino Castro, Fabiano Araújo Cunha, Fernando Oliveira Costa, Elton Gonçalves Zenóbio, Maria Aparecida Gonçalves de Melo Cunha

Abstract


ABSTRACT

Different periodontal surgical techniques have been proposed for the treatment of periodontal recessions. Among these, the graft of gingival connective tissue stands out for the high predictability of success. This work compared the clinical outcomes of treatment of periodontal recessions, using the gingival connective tissue grafts and acellular dermal matrix. A total of 72 recessions constituted the sample, divided equally into 2 groups. Group 1: treated with acellular dermal matrix graft (MDA) associated with the displaced: Group 2: treated with gingival connective tissue graft, also associated with the flap offset coronally. We evaluated the clinical parameters of probing depth, insert, clinical periodontal recession towards coronal-apical diameter mesio-distal of recessions, keratinized and mucosa thickness flap and influence of grafts in relation to root coverage. The initial measures were compared to those obtained with 45, 90 and 120 days after surgery. No statistically significant differences were found between the groups in terms of reduction of periodontal recessions, keratinized and mucosa flap thickness and of grafts in relation to root coverage. The Group 2 (CG) showed statistically significant reduction in the depth of drilling and clinical level of insertion, compared to group 1 (MDA). However, these differences were not clinically relevant. It was concluded that both the gingival connective tissue graft as the acellular dermal matrix can be used in the treatment of periodontal recessions, with a high predictability of success.

Keywords: Gingival recession, connective tissue graft, acellular dermal matrix, periodontal surgery, gum recession, root coverage.

Full Text:

PDF

References


REFERENCES

Bouchard P. Subepithelial connective tissue grafts in the treatment of gingival recessions. A comparative of 2 procedures. Journal of Periodontology. 1994; 65: 929-36.

Blomlof J. Effect of different concentrations of EDTA on smear removal and collagen exposure in periodontitis affected root surfaces. Journal of Clinical Periodontology. 1997; 24: 534-37.

Callan DP. Use of acellular dermal matrix allograft material in dental implant treatment. Dental Surgery Products. 1996; 10:14-7.

Carranza Jr., FA. & Newman MG. Periodontia Clínica. 1997; 5: 350-83.

Dodge JR. Root coverage without a palatal donor site, using an acellular dermal graft. Periodontal Insights. 1998: 5-9.

Grisi DC. Enxertos conjuntivo subepitelial e de matriz dérmica acelular no tratamento de recessões gengivais. Revista da Associação Paulista de Cirurgiões Dentistas, 2001; 55:4-9.

Harris RJ. The connective tissue and partial thickness double pedicle graft: a predictable method of obtaining root coverage. Journal of Periodontology. 1992; 63:477-86.

Harris RJ. The connective tissue with partial thickness double pedicle graft: the results of 100 consecutively treated defects. Journal of Periodontology. 1994; 65: 448-61.

Harris RJ. Root coverage with a connective tissue with partial thickness double pedicle graft and an acellular dermal matrix graft: a clinical and histological evaluation of a case report. Journal of Periodontology. 1998; 69: 1305-11.

Harris RJ. A comparative study of root coverage obtained with an acellular dermal matrix versus a connective tissue graft: results of 107 recession defects in 50 consecutively treated patients. International Journal of Periodontics and Restaurative Dentistry. 2000; 20: 51-9.

Harris RJ. Acellular dermal matrix used for root coverage: 18-month folow-up observation. International Journal of Periodontics Restaurative Dentistry. 2002; 22: 156-63.

Henderson RD. Predictable multiple site root coverage using dermal matrix allograft. Journal of Periodontology. 2001; 72: 571-82.

Jahnke PV. Thick free gingival and connective tissue autografts for root coverage. Journal of Periodontology. 1993; 64: 315-22.

Jepsen KH. Treatment of gingival recession with titanium reinforced barrier membranes versus connective tissue grafts. Journal of Periodontology. 1998; 69: 383-91.

Joshipura KJ. Gingival recession: Intra oral distribution and associated factors. Journal of Periodontology. 1994; 65: 864-71.

Langer B & Langer L. Subepithelial connective tissue graft technique for root coverage. Journal of Periodontology. 1985; 56: 715-20.

Liversey S. An acellular dermal transplant process from human allograft skin retains normal extracelular matrix components and ultrastructural characteristics. American Association of Tissue Banks Conference. 1994.

Miller PD & Craddock RD. Surgical advances in the coverage of exposed roots. Journal of Periodontology. 1996; 3: 103-8.

Nelson, SW. The subpedicle connective tissue graft. A bilaminar reconstructive procedure for the coverage of desnuded root surfaces. Journal of Periodontology. 1987; 58: 95-102.

Novaes Jr. Comparative 6-Month Clinical Study of a Subepithelial Connective tissue Graft and Acellular Dermal Matrix Graft for the Treatment of Gingival Recession. Journal of Periodontology. 2001; 72: 1477-84.

Oliver MJ. Multiple denuded root surfaces. Complete coverage with a one-stage subepithelial connective tissue graft. Oral Health. 1987; 77: 51-8.

Paolantônio M. Subpedicle connective tissue graft versus free gingival graft in the coverage of exposed root surfaces: a 5- year clinical study. Journal of Clinical Periodontology. 1997; 24: 51-6.

Paolantônio M. Subpedicle acelular dermal matrix graft in the treatment of gingival recessions: A comparative 1-year clinical study. Journal of Periodontology. 2002; 1299-1307.

Pini Prato G. Guided tissue regeneration versus mucogingival surgery in the treatment of human buccal gingival recession. A 4-year folow-up study. Journal of Periodontology.1996; 67:1216-23.

Raetzke PB. Covering localized areas of root exposure employing the envelope technique. Journal of Periodontology. 1985; 56: 897.

Rosetti EP. Treatment of gingival recession: comparative study between subepithelial connective tissue graft and guided tissue regeneration. Journal of Periodontology. 2000; 71: 1441-47.

Serino G. The prevalence and distribution of gingival recession in subjects with a hight standard of oral hygiene. Journal of Clinical Periodontology. 1994; 21: 57-63.

Silvertein LH & Callan DP. An acellular dermal matrix allograft substitute for palatal donor tissue. Postgrad Dentistry. 1996; 3: 14-21.

Silverstein LH. Fundamentally changing soft tissue grafting. In: Dentistry Today. 1997; 16: 3.

Stoner J & Mazdasna S. Gingival recession in lower incisor region of 15- year old subjects. Journal of Periodontology. 1980; 51: 74-6.

Tal H. Subgingival acellular dermal matrix allograft for the treatment of gingival recession. Journal of Periodontology. 1999; 70: 1118-24.

Wennstrom JL & Zucchelli G. Increased gingival dimensions, A significant factor for successful outcome of root coverage procedures? A two year prospective clinical study. Journal of Clinical Periodontology. 1996; 23: 770- 7.




DOI: http://dx.doi.org/10.24294/as.v1i2.189

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Creative Commons License

This site is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.