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

Resumen

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.