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. 2019 Mar-Apr;23(2):137-144.
doi: 10.4103/jisp.jisp_308_18.

Comparative evaluation of clinical efficacy of coronally advanced flap alone and in combination with placental membrane and demineralized freeze-dried bone allograft in the treatment of gingival recession

Priyanka Chopra  1 , Jayashree Kassal  1 , Sujata Surendra Masamatti  1 , Harpreet Singh Grover  1
Affiliations

Comparative evaluation of clinical efficacy of coronally advanced flap alone and in combination with placental membrane and demineralized freeze-dried bone allograft in the treatment of gingival recession

Priyanka Chopra et al. J Indian Soc Periodontol. 2019 Mar-Apr.

Abstract

Background: Guided tissue regeneration is a very commonly employed technique for treating recession defects. However, achieving the required space beneath the membrane is often difficult.

Aim and objectives: The purpose of the present study was to compare and evaluate the clinical efficacy of coronally advanced flap (CAF) alone or in combination with amnion membrane (AM) or chorion membrane (CM) and demineralized freeze-dried bone allografts (DFDBAs) in the management of gingival recession (GR) defects.

Materials and methods: The sample size (Miller's Class I and Class II GR-type defects) consisted of thirty patients which were stratified into three groups randomly (ten for each group). Group A patients were treated with only CAF and Group B patients were treated by CAF in combination with CM and DFDBA. Similarly, Group C patients were treated by CAF in combination with AM and DFDBA. Clinical parameters such as gingival index, GR depth, GR width, relative attachment level, and width of keratinized tissue were assessed at baseline and 3 months postoperatively.

Results: Inter- and intragroup data were analyzed by paired t-test. The percentage of root coverage obtained in the study groups was 60%, 78%, and 63%, respectively, for Groups A, B, and C. Statistically significant difference was obtained in the clinical parameters of Group B which was treated with CM and DFDBA.

Conclusions: Combination of DFDBA and placental membrane (chorion/amnion) in CAF procedure provided an additional benefit over CAF alone in the treatment of Class I and II GR defects.

Keywords: Amnion membrane; chorion membrane; demineralized freeze-dried bone allograft; gingival recession.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Consort flowchart of the study. n – sample size
Figure 2
Figure 2
Preoperative recession defect measurement at baseline
Figure 3
Figure 3
Group A – Two divergent vertical releasing incisions made beyond mucogingival junction. An intrasulcular incision is made to connect the two vertical releasing incisions
Figure 4
Figure 4
Group A – Partial-thickness flap elevated
Figure 5
Figure 5
Group B – Demineralized freeze-dried bone allografts followed by human chorion membrane placed
Figure 6
Figure 6
Group C – Partial-thickness flap elevated
Figure 7
Figure 7
Group C – Demineralized freeze-dried bone allografts placed evenly over the root surface
Figure 8
Figure 8
Group C – Human amniotic membrane is positioned over the graft, and flap is relieved of any tension
Figure 9
Figure 9
Group A – Healing at 3 months
Figure 10
Figure 10
Group B – Root coverage at 3 months healing
Figure 11
Figure 11
Group C – Root coverage at 3 months healing
Graph 1
Graph 1
% Root coverage
See this image and copyright information in PMC

References

    1. Sullivan HC, Atkins JH. Free autogenous gingival grafts 3. Utilization of grafts in the treatment of gingival recession. Periodontics. 1968;6:152–60. - PubMed
    1. Serino G, Wennström JL, Lindhe J, Eneroth L. The prevalence and distribution of gingival recession in subjects with a high standard of oral hygiene. J Clin Periodontol. 1994;21:57–63. - PubMed
    1. Wennström JL. Mucogingival therapy. Ann Periodontol. 1996;1:671–701. - PubMed
    1. Cairo F, Pagliaro U, Nieri M. Treatment of gingival recession with coronally advanced flap procedures: A systematic review. J Clin Periodontol. 2008;35:136–62. - PubMed
    1. Pini-Prato G, Tinti C, Vincenzi G, Magnani C, Cortellini P, Clauser C, et al. Guided tissue regeneration versus mucogingival surgery in the treatment of human buccal gingival recession. J Periodontol. 1992;63:919–28. - PubMed