Clinical comparison of coronary displaced fl ap and sub-epithelial connective tissue graft with or without enamel matrix protein derivative for gingival recession coverage. Clinical case presentation

Ana Patricia Vargas Casillas, Blanca Itzel Mendoza Espinosa, Socorro Aída Borges Yáñez


The present article described a clinical case where it was
assessed whether aggregation of enamel matrix derivative (EMD) to the procedure of coronary-advanced flap with sub-epithelial connective tissue graft (CAF + SCTG) would improve the amount of root coverage in Miller’s class I and II gingival recessions when compared to the same isolated procedure in a patient suffering multiple gingival recessions, in a 6 month time-span. Twelve gingival recessions were included in the study: six treated with (CAF + SCTG + EMD) and six treated with (CAF + SCTG) in different quadrants. At beginning of procedure as well as six months later, the following clinical parameters were measured: gingival recession depth (RD), depth to probing (PD), clinical insertion level (CIL) and
width of keratinized tissue (KT) in apex-coronary direction. A p < 0.05 was considered statistically signifi cant. Results established that after a six month procedure CAF + SCTG + EMD and CAF + SCTG produced signifi cant root coverage, respective averages were 2.83 ± 1.16 mm (p = 0.001) and 2.50 ± 0.83 mm (p = .002). All gingival recessions treated with EMD experienced 100% root coverage, sites treated with CAF + SCTG + EMD exhibited coverage of only 65.3%. When comparing results at six months, better results were
observed with CAF + SCTG + EMD with respect to clinical insertion level (p = .02) and root coverage (p = .06). Nevertheless, neither the difference of clinical level insertion nor the gain in root coverage resulted significant. Additionally, no significant differences were observed between PD and KT. Conclusion: The present clinical case did not show additional benefi ts when EMD were aggregated to the CAF + SCTG in the coverage of multiple Miller’s class I and class II gingival recessions.

Palabras clave

Gingival recession, coronary-advanced fl ap, connective tissue sub-epithelial graft, enamel matrix derivatives, periodontal regeneration.

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ISSN: 1870-199X