Abstract
Porcine acellular dermal matrix has recently been introduced in dentistry as an alternative to the gold standard connective tissue graft especially for the use in gingival recession treatments and soft tissue augmentation in implant surgery. Connective tissue grafts are inconvenient and require a second surgical site leading to greater morbidity, longer surgical procedures, and a more painful postoperative phase for the patient. Other options such as allografts have ethical concerns and are less available in Europe. Thus, dental professionals have sought other techniques and materials. Porcine acellular dermal matrix results in periodontal recession treatment with a gain in recession coverage as well as increased keratinized tissue and soft tissue augmentation. This leads to more keratinized mucosa and greater tissue thickness. Many studies have been published using collagen matrices, but a few strictly use porcine acellular dermal matrix, which have been studied in prospective randomized clinical trials with a large number of patients and longer follow-up periods (more than 5 years). Nevertheless, more data are needed to confirm that the porcine acellular dermal matrix is a suitable alternative although its favourable results to date suggest a positive future.
Highlights
Alternatives include allografts (AlloDerm) which is an acellular dermal matrix originally introduced to treat burn patients in the year 1992 and has since been used in medical and dental reconstructive surgery as a substitute for CTG with no risk of rejection or disease transmission [10, 11]
In vitro and in vivo investigations proved that PADM can increase growth and proliferation of human gingival fibroblasts, osteoblasts, and endothelial cells revealing a capacity for significant revascularization of the collagen structure during early healing [16,17,18]
Pietruska et al compared the results of both procedures in the treatment of multiple gingival recessions of Miller Class I and II in the mandible via a modified coronal advanced tunnel technique (MCAT) [24, 25]. e mean root coverage data on PADM was 53.20% and 83.10% with the CTG after one year
Summary
One of the main reasons that collagen matrices have been introduced in dentistry is to avoid using connective tissue grafts for the motives mentioned earlier in this article. Favourable results were observed in a 12-month follow-up by Cosgarea et al Evaluating PADM in multiple gingival recession treatments using a modified coronally advanced technique included Miller Class III recessions [21]. In 2019, Gurlek et al compared PADM and CTG and combined these materials with a modified coronal advanced flap in the treatment of multiple recessions of Miller class I and II [1, 22] Both procedures were very effective during the 18-month follow-up, CTG resulted with a higher gain in keratinized tissue. Pietruska et al compared the results of both procedures in the treatment of multiple gingival recessions of Miller Class I and II in the mandible via a modified coronal advanced tunnel technique (MCAT) [24, 25]. It is still early to use PADM as a substitute for autogenous connective tissue grafts in mucogingival surgery; more studies are needed to defend this position with longer-term evaluations
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