Long-term results after treatment of multiple adjacent gingival recessions with the modified coronally advanced tunnel and a porcine acellular dermal matrix.

Abstract

<p>Objective: To evaluate the long-term clinical results after treatment of multiple adjacent recession type (RT) I and II gingival recessions treated with the modified coronally advanced tunnel (MCAT) in conjunction with a porcine acellular dermal matrix (PADM).<br /> Method and materials: Nine periodontally healthy nonsmoking patients (seven women, 37.5&nbsp;±&nbsp;7.36&nbsp;years old) with a total of 41 adjacent RT I (n&nbsp;=&nbsp;23) and RT II (n&nbsp;=&nbsp;18) gingival recessions exhibiting a minimum depth of 2&nbsp;mm were treated by means of MCAT+PADM. Recession depth and width, width of attached and keratinized tissue, probing depths, and clinical attachment level were measured at baseline and at 1 and 4&nbsp;years postsurgically. The primary outcome variable was complete root coverage (ie 100% root coverage), while secondary outcomes were mean root coverage and increase in keratinized tissue and attached gingiva widths.<br /> Results: At 1 and 4&nbsp;years, statistically highly significant (P&nbsp;&lt;&nbsp;.001) root coverage was obtained in all nine patients compared to baseline. Mean root coverage decreased in these nine patients from 72.05&nbsp;± 30.18% at 1&nbsp;year to 56.79&nbsp;±&nbsp;27.53% at 4&nbsp;years. Complete root coverage was obtained in 18 gingival recessions at 1&nbsp;year (baseline RT: 12 RT I, 6 RT II) and in seven gingival recessions (5 RT I, 2 RT II) at 4&nbsp;years. Most root coverage occurred in the first year postsurgically, showing a statistically significant decrease between the first and fourth year (P&nbsp;=&nbsp;.003). Mean width of attached gingiva increased statistically significantly (P&nbsp;&lt;&nbsp;.05) from 2.85&nbsp;±&nbsp;1.08&nbsp;mm to 3.14&nbsp;±&nbsp;1.08&nbsp;mm at 1&nbsp;year with a statistically significant decrease at 4&nbsp;years. At 1&nbsp;year, 78.05% of gingival recessions showed a root coverage&nbsp;&gt;&nbsp;50%, and 68.29% still exhibited a root coverage&nbsp;&gt;&nbsp;50% at 4&nbsp;years.<br /> Conclusion: The use of MCAT+PADM represents a valuable treatment option for multiple adjacent maxillary and mandibular RT I and II gingival recessions on a long-term basis.</p>.