Healing of localized gingival recessions treated with a coronally advanced flap alone or combined with an enamel matrix derivative and a porcine acellular dermal matrix: a preclinical study

Clin Oral Investig. 2016 Sep;20(7):1791-800. doi: 10.1007/s00784-015-1680-4. Epub 2015 Nov 27.

Abstract

Objective: This study aimed to evaluate the effects of a porcine acellular dermal matrix (PADM) with or without an enamel matrix derivative (EMD) on gingival recession defects treated with a coronally advanced flap (CAF) in dogs.

Materials and methods: Miller class II gingival recession defects (5 mm wide and 7 mm deep) were surgically created on the labial side of bilateral maxillary canines in 12 dogs. After 8 weeks of plaque accumulation, the 24 chronic defects were randomly assigned to one of the following 4 treatments: CAF, CAF with PADM (CAF/PADM), CAF with EMD (CAF/EMD), and CAF with EMD and PADM (CAF/EMD/PADM). The animals were sacrificed 10 weeks after surgery for histologic evaluation.

Results: In all groups, root coverage was obtained to a varying degree. PADM was well incorporated in gingival connective tissue in the CAF/PADM and in the CAF/EMD/PADM groups. The height of newly formed bone was significantly greater in the CAF/EMD/PADM group than in the CAF and CAF/PADM groups. New cementum with periodontal ligament-like tissue was predominantly found in the CAF/EMD and CAF/EMD/PADM groups. The CAF/EMD/PADM group showed the greatest amount of new cementum among the groups examined, although the difference was not statistically significant.

Conclusion: Within the limitations of the present study, it can be concluded that CAF/EMD/PADM treatment may promote periodontal regeneration in gingival recession defects.

Clinical relevance: The present results suggest that the combination of EMD and PADM in conjunction with CAF may represent a promising approach for treating single Miller class II gingival recessions.

Keywords: Animal study; Enamel matrix derivative; Gingival recession defects; Periodontal regeneration; Porcine acellular dermal matrix; Root coverage.

MeSH terms

  • Acellular Dermis*
  • Animals
  • Combined Modality Therapy
  • Dental Enamel Proteins / pharmacology*
  • Dogs
  • Gingival Recession / drug therapy*
  • Gingival Recession / surgery*
  • Gingivoplasty / methods
  • Regeneration
  • Surgical Flaps*
  • Swine
  • Wound Healing / physiology*

Substances

  • Dental Enamel Proteins