Root Coverage with Tunneling Technique or Modified Advanced Flap Associated with Acellular Dermal Matrix: Results from 6 Months Randomized Clinical Trial

Objectives: This study compared two surgical techniques using acellular dermal matrix (ADM) for the treatment of multiple gingival recessions.

Material And Methods: Twenty patients, with bilateral RT1 gingival recessions, were selected. One side received a modified extended coronally advanced flap (MECAF), and the contralateral side a supra-periosteal flap (TUN). The evaluated parameters were probing depth (PD), relative clinical attachment level, gingival index, gingival recession height (GR), width of keratinized tissue, keratinized tissue thickness, and gingival recession area at baseline and 6 months postoperative. Pain was evaluated weekly, using a visual analog scale (VAS) during first month postoperative.

Results: Both groups were effective in reducing GR (ΔGR: MECAF 2.28 mm; TUN 1.93 mm), without significant differences. The % of root coverage was numerically superior favoring MECAF (MECAF 61.24%; TUN 56.07%), without significant differences between groups. VAS scale failed to provide differences between groups.

Conclusions: Both treatment were effective in root coverage and might be valuable for the treatment of multiple gingival recessions. The use of vertical releasing incisions and a flap design including the papillae did not hamper root coverage.

Clinical Relevance: This study compared two techniques for use of ADM in large multiple gingival recessions. Within its limitations, both treatments successfully achieved root coverage and were able to reduce gingival recession. It is expected a partial root coverage when using these techniques in large gingival recessions. The study failed to provide significant differences between groups. The use of modified extended coronally advanced flap may be advisable for the treatment of multiple gingival recessions, specially involving large defects when using ADM, to avoid early matrix exposure.