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Subepithelial connective tissue graft with or without enamel matrix derivative for the treatment of multiple Class III‐IV recessions in lower anterior teeth: A 3‐year randomized clinical trial
Author(s) -
Mercado Faustino,
Hamlet Stephen,
Ivanovski Saso
Publication year - 2020
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1002/jper.19-0058
Subject(s) - medicine , enamel matrix derivative , gingival recession , dentistry , randomized controlled trial , anterior teeth , connective tissue , clinical attachment loss , periodontitis , surgery , pathology , regeneration (biology) , biology , microbiology and biotechnology
Background This study compared clinical and patient‐centered outcomes of subepithelial connective tissue graft (CTG) with and without enamel matrix derivative (EMD) in the treatment of multiple Class III‐IV Miller periodontal recession (REC) defects on mandibular anterior teeth. Methods This randomized clinical study evaluated 41 patients at 3 years follow‐up. One hundred and fifty‐six teeth were divided into two groups: test (CTG‐EMD, 79 teeth) and control (CTG only, 77 teeth). Clinical REC, keratinized tissue (KT) width, percentage of root coverage, patient‐centered outcomes were compared between the two groups. Results At 36 months follow‐up, patient level analysis showed that REC in the test group reduced significantly (5.71 ± 0.58 mm to 1.57 ± 0.85 mm) compared with the control group (5.94 ± 0.46 mm to 2.51 ± 0.62 mm) ( P < 0.001), while KT width increased in the test group (1.51 ± 0.26 mm to 4.18 ± 0.34 mm) and was significantly greater than the control group (1.65 ± 0.21 mm to 2.90 ± 0.20 mm) ( P < 0.001). At 36 months, tooth level analysis (Class III and Class IV groups) found less residual REC and increased KT in the test group compared with the control group ( P < 0.01). Significantly less pain was reported at 2, 7, and 14 days follow‐up post‐surgery in the test group ( P < 0.001). Conclusions The addition of EMD to CTG results in improved root coverage outcomes and higher amounts of KT width 36 months after treatment of Class III‐IV REC on mandibular anterior teeth. The adjunctive use of EMD also resulted in significantly reduced pain 14 days post‐surgery.