Medizinische Universität Graz - Research portal
Selected Publication:
Rieder, M.
Treatment of Localized Gingival Recession with an Enamel Matrix Protein Coated Collagen Matrix – A Randomized Controlled Trial
Zahnmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2023. pp. 49
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- Authors Med Uni Graz:
- Advisor:
- Arefnia Behrouz
- Payer Michael
- Altmetrics:
- Abstract:
- Background: In periodontal plastic surgery, there are several options to cover exposed root surfaces using various proven surgical methods and materials. To reduce the morbidity caused by autologous gingiva harvesting, the utilization of xenogeneic collagen matrices (CM; Mucoderm®, Botiss, Zossen, Germany) is a standard treatment option. The additional application of enamel matrix derivatives (EMD; Emdogain®, Straumann, Basel, Switzerland) could promote regeneration and thereby superior root coverage. This study aims to evaluate the influence of the additionally use of EMD in the treatment of gingival recession defects using a coronally advanced flap (CAF) and a CM (CAF + CM ± EMD) by means of digital and clinical assessment methods. Materials and Methods: In this prospective, randomized, controlled study, recession height and area, width and thickness of keratinized gingiva, volume change, pocket probing depth and the clinical attachment level were measured at the baseline and followed up for one year. 15 patients (n = 15) with 24 gingival recession defects (Recession Type 1 after Cairo/Miller Class I or II) were treated over a four-year time period (2016-2021) after randomly being assigned into two treatment groups. The digital assessment was carried out 3 months after surgery using intraoral scans. Results: Both treatment modalities resulted in a significant clinical improvement (p < 0,001). On average, the digitally assessed root coverage of Group A (CAF + CM) was not statistically superior compared to group B (CAF+CM+EMD) with 72±28% and 31±32%, respectively (p = 0.094). Clinically, outcomes showed stable results one year after surgery. Additional width of keratinized tissue (WKT) was demonstrated in both groups one year after surgery (group A/CAF + CM: 1.61 mm and group B/CAF + CM + EMD: 1.46 mm; p = 0.690) but with superior results in group A regarding the thickness of keratinized gingiva (p = 0.044). Conclusions: The present study showed that there were no statistically significant differences in the root coverage results in the CAF + CM + EMD group compared to the CAF + CM group. The adjunctive use of EMD to a coronally advanced flap and collagen matrix in the treatment of gingival recession defects does not appear to have any clinical benefit. The digital assessment methods of this study demonstrate reliable techniques using intraoral scans, without the need to penetrate the gingiva, take impressions, or use a digital calliper tool.