Tunnel technique versus coronally advanced flap with acellular dermal matrix graft in the treatment of multiple gingival recessions

Aim The aim of this randomized controlled clinical study was to evaluate the outcomes of acellular dermal matrix ( ADM ) graft in combination with tunnel technique ( TUN ) on root coverage, aesthetics, and patient satisfaction and to compare with coronally advanced flap ( CAF )+ ADM in the treatment of multiple gingival recessions. Material and Methods A total of 20 patients with 58 Miller Class I multiple recessions ≥3 mm were included and divided into TUN + ADM and CAF + ADM groups. At baseline and 12 months, probing depth ( PD ), clinical attachment level ( CAL ), recession height ( RH ) and width ( RW ), keratinized tissue height ( KT ), gingival thickness, and complete and mean root coverage ( CRC , MRC ) were evaluated. Patient satisfaction and root coverage aesthetic scores ( RES ) were also assessed. Results Mean root coverage was 75.72% in TUN + ADM and 93.81% in CAF + ADM . Intragroup comparisons revealed significant differences at 12 months for all parameters in both groups ( p  < 0.05). Intergroup differences were found to be statistically significant for RH and RW reduction, KT increase, CAL gain, MRC , CRC , and RES in favour of CAF + ADM group ( p  < 0.05). Conclusion Both techniques were effective in root coverage of multiple recessions; however, better clinical results were achieved with CAF and ADM combination.