Denuded Root Surfaces Research Articles

Lateral pedicle graft for the treatment of isolated tooth recession

ABSTRACT Gingival recession is defined as the apical migration of the gingival margin from its normal position leading to exposure of the root surface. It not only poses problems in maintaining good oral hygiene but also simultaneously hampers the esthetics. In the present case, the patient came up with a complaint of a denuded root surface due to apical migration of the gingival margin and also a complaint of sensitivity in the same. The case was diagnosed as chronic generalized gingivitis with localized periodontitis in relation to 31. Based on the clinical outcomes, the lateral pedicle graft (LPG) technique was performed. A complete coverage of the exposed root surface was achieved. This case report shows that a simple technique of root coverage like LPG can result in the successful coverage of the denuded root surface.

A Single-Step Root Coverage Procedure Using Modified Bridge Flap Technique and De-epithelialized Gingival Unit Graft: A Prospective Clinical Study

Abstract Background: The mucogingival conditions associated with the recession defects at the mandibular anterior region, not only make plaque control difficult to be performed by the patient but also pose a problem in passively advancing the tissues at the recipient site. This surgical technique is used to treat multiple recession defects in the mandibular anterior region. Materials and Methods: Twenty-five sites in 17 subjects (11 women and 6 men) underwent modified bridge flap and de-epithelized gingival unit graft (d-GUG) as a single-step treatment modality to cover the denuded root surface, as well as increase the width of keratinized gingiva in recession type 1 gingival recession defects in the mandibular anterior region. Results: Nearly 60% of sites in our study showed complete root coverage, with a mean root coverage percentage of 88.08%. Furthermore, keratinized tissue width, keratinized tissue thickness as well as vestibular depth showed statistically significant increases as compared to baseline levels. Conclusion: Thus, the modified bridge flap technique using d-GUG within the limitations of our study design, showed promising results in terms of recession coverage as well as management of the difficult mucogingival conditions at the mandibular anterior region.

Periodontal tissue regeneration with cementogenesis after application of brain-derived neurotrophic factor in 3-wall inflamed intra-bony defect.

The purpose of this study is to investigate regenerative process by immunohistochemical analysis and evaluate periodontal tissue regeneration following a topical application of BDNF to inflamed 3-wall intra-bony defects. Brain-derived neurotrophic factor (BDNF) plays a role in the survival and differentiation of central and peripheral neurons. BDNF can regulate the functions of non-neural cells, osteoblasts, periodontal ligament cells, endothelial cells, as well as neural cells. Our previous study showed that a topical application of BDNF enhances periodontal tissue regeneration in experimental periodontal defects of dog and that BDNF stimulates the expression of bone (cementum)-related proteins and proliferation of human periodontal ligament cells. Six weeks after extraction of mandibular first and third premolars, 3-wall intra-bony defects were created in mandibular second and fourth premolars of beagle dogs. Impression material was placed in all of the artificial defects to induce inflammation. Two weeks after the first operation, BDNF (25 and 50 μg/mL) immersed into atelocollagen sponge was applied to the defects. As a control, only atelocollagen sponge immersed in saline was applied. Two and four weeks after the BDNF application, morphometric analysis was performed. Localizations of osteopontin (OPN) and proliferating cell nuclear antigen (PCNA)-positive cells were evaluated by immunohistochemical analysis. Two weeks after application of BDNF, periodontal tissue was partially regenerated. Immunohistochemical analyses revealed that cells on the denuded root surface were positive with OPN and PCNA. PCNA-positive cells were also detected in the soft connective tissue of regenerating periodontal tissue. Four weeks after application of BDNF, the periodontal defects were regenerated with cementum, periodontal ligament, and alveolar bone. Along the root surface, abundant OPN-positive cells were observed. Morphometric analyses revealed that percentage of new cementum length and percentage of new bone area of experimental groups were higher than control group and dose-dependently increased. These findings suggest that BDNF could induce cementum regeneration in early regenerative phase by stimulating proliferation of periodontal ligament cells and differentiation into periodontal tissue cells, resulting in enhancement of periodontal tissue regeneration in inflamed 3-wall intra-bony defects.

A scanning electron microscopical study of initial changes in human premolars teeth after orthodontic tooth movement

scanning electron microscope was used to study the effect of orthodontic tooth movement by using a force of 50 grams on the pressure side of 2l upper left premolarmt for 5- 75 days while the contralaterl side 14 teeth were used as a control. In order toruiy the morphology and occurrence of root resorptions, the organic tissue was removedrsigg sodium hypochlorite and the denuded root surface were re—examined in thescanning electron microscope. Initially, tissue affected by pressure was mainly located inhe marginal region and subsequently the mid- portion of the roots became generallyuri genced. The resorption process of cementum begins after 5 days as around cavitiesmeasuring about 4u. Further resorption in cementum was characterized by measuringsmall, thin—walled round lacunae which confluence into extensive, shallow resorptionsafter 25 days and more

Comparative histological evaluation of two PRF formulations (PRF High and PRF Medium) on quality of life and healing outcome of apicomarginal defects: A randomized clinical trial

The objective of this randomized clinical trial was to investigate the effects of two PRF formulations (PRF High and PRF Medium) on quality of life and healing outcome (2D and 3D) of apicomarginal defects.Patients presenting with endodontic lesions and concomitant periodontal communication were randomly allocated to PRF High and PRF Medium groups. The treatment protocol in each group included a periapical surgical procedure with placement of PRF clot and membrane in the bony defect and on the denuded root surface, respectively. Quality of life was assessed for 1 week after surgery following a modified version of the patient's perception questionnaire. Postoperative pain was assessed using a visual analog scale. Clinical and radiographic evaluations were performed using Rud and Molven 2D criteria and Modified PENN 3D criteria. Buccal bone formation was assessed using sagittal and corresponding axial sections in CBCT. Histological analysis was performed using hematoxylin and eosin (H and E) staining and attaching primary antibodies to tissue sections.In total, 40 patients were enrolled in the trial (N = 20 per group). PRF Medium group patients reported significantly less swelling on the 1st (p = 0.036), 2nd (p = 0.034), and 3rd (p = 0.023) days, and average pain on the 2nd (p = 0.031), 3rd (p = 0.03), and 4th (p = 0.04) days postoperatively. The difference in success rate for periapical healing was non-significant between the PRF Medium group (89.5%) and PRF High group (90%), in both 2D and 3D imaging (p = 0.957). The formation of buccal bone was observed in five cases (26.3%) and four cases (20%) in the PRF Medium and PRF High groups, respectively, with a non-significant difference (p = 0.575). PRF Medium clots had a loose fibrin structure with a significantly higher number of neutrophils (473.79 ± 82.89 per mm2) than PRF High clots, which had a dense structure and fewer neutrophils (253.15 ± 63.86 per mm2) (p = 0.001). Autologous platelet concentrates (APCs) promoted satisfactory periapical healing, with no significant difference between the groups.Within the limitations of the study, it seems that PRF Medium should be preferred over PRF High when the patients’ quality of life is the priority.

Multiple Subperiosteal Sling Sutures for Connective Tissue Graft Stabilization in the Treatment of Multiple Recession Defects Utilizing Subperiosteal Tunnels via VISTA and Intrasulcular Access.

This report describes the utilization of multiple subperiosteal sling (SPS) sutures to stabilize connective tissue grafts in the treatment of multiple recession defects using subperiosteal tunnels via vestibular and intrasulcular accesses. The SPS sutures engage only the graft and stabilize it against teeth inside the subperiosteal tunnel without engaging the overlying soft tissue, which is neither sutured nor coronally advanced. At sites with deep recessions, the graft is left exposed over the denuded root surfaces and allowed to epithelialize, which results in root coverage and increased attached keratinized tissue. Further controlled studies are required to investigate the predictability of this treatment approach.

Comparative study of effects of Triphala and Tetracycline gel on root conditioning

Background: Remnants of dental calculus, contaminated cementum, and subgingival plaque act as a physical barrier between periodontal tissues and root surfaces, which inhibits the formation of new attachment. Treatment of denuded root surface using various chemicals and antimicrobial agents with scaling and root planing helps in active periodontal regeneration. Aim: The aim of this study was to evaluate and compare the demineralizing effects of Triphala and 1% Tetracycline HCl gel on root conditioning using a Scanning Electron Microscope. Settings and design: A total of 50 hemi-sectioned root samples were obtained from 25 extracted, and root planed samples. These were divided into two groups, Group 1: 1% Tetracycline HCl gel and Group 2: Triphala. Materials and method: The two root conditioning agents were applied with cotton pellets on the sectioned roots. The samples were then examined under the scanning electron microscope. Statistical analysis used: Data obtained was compiled on a MS Office Excel Sheet. Inter group comparison was done using Mann Whitney U test. Comparison of frequencies of categories of variables with groups was done using Chi Square Test. Results: The root conditioning agents used in this study were found to be equally effective in removing the smear layer. 

Treatment of Localized Gingival Recession Using Gingival Unit Grafts: An 18-month Follow-up Study

The study aimed to longitudinally evaluate the efficacy of gingival unit grafts (GUGs), a modification of free gingival grafts, in the management of Miller's class I and class II recession defects in mandibular anterior region, over a period of 18 months. 17 subjects with 21 recession defects in mandibular anterior region were treated using GUG. Clinical parameters of recession depth (RD), clinical attachment levels (CALs), and keratinized tissue width (KTW) were recorded at baseline, 1, 6, and 18 months. Patient-centered outcomes were measured using a visual analog scale (VAS) for pain and discomfort on 14th postoperative day and for treatment satisfaction at the end of 18 months. There was a statistically significant improvement in RD, CAL, and KTW at 18 months when compared to baseline levels. A mean root coverage (MRC) percentage of 84.76 ± 11.79% was achieved at the end of 18 months. Patient-related outcomes for VAS for pain and discomfort as well as treatment satisfaction showed favorable results. GUG can be used as a predictable treatment modality for Miller's class I and class II recession defects in mandibular anterior region. The results obtained can be well maintained over 18-month period with optimal maintenance care. The advantage of involving marginal gingiva in GUG results in a well-contoured graft, which increases the ease of adaptation and suturing. The biological characteristic of intact marginal vasculature results in early integration of graft into the recipient area and greater success in graft survival over denuded root surface, causing better long-term RC outcomes.

Lateral Pedicle Graft Procedure for the Treatment of Isolated Tooth Recession- A Case Report

Gingival recession is defined as the apical migration of the gingival margin from its physiologic level which further causes pathologic exposure of root surfaces. Mucogingival esthetic surgery includes the treatment of mucogingival esthetic alterations. The Mucogingival problems may be caused by gingival recession which is often associated with non-carious cervical lesion or by root caries or by altered passive eruption. Root coverage is achieved by many procedures like free gingival autografts, pedicle graft and connective tissue grafts. Recession can be treated by surgical or non-surgical means. surgical procedure includes various methods of increasing the width of keratinized tissue such as frenectomy in case of high frenal attachment & root coverage procedures and nonsurgical approach include-restorations, crowns, veneers and gingival masks. Lateral displaced pedicle flap was first described by Grupe and Warren in 1956 which was indicated in area to cover isolated apical migration of gingiva, & denuded root surfaces that have adequate amount of donor tissue adjacent to the recipient site. In few clinical studies it is seen that the success rate with Lateral pedicle graft is 70%, it is preferred over free gingival autografts in narrow and shallow gingival defects. This case report present the predictability of root coverage by using Lateral pedicle grafts in single tooth narrow and shallow gingival recession. Keywords: Lateral pedicle graft, Gingival recession, Attachment loss, Graft.

Demineralized freeze-dried bone allograft with Periocol® membrane versus Perioglas® with Periocol® membrane in the treatment of intrabony defects: A case report

Introduction: Intrabony defects associated with periodontal pockets can be successfully treated with bone graft and Guided Tissue Regeneration membrane (GTR). Demineralized freeze-dried bone allograft (DFDBA) consists primarily of collagen including bone growth and differentiation factors like Bone Morphogenetic Proteins. Perioglas® is a bioactive glass that is osteoconductive, composed entirely of elements naturally occurring in the body and bonds directly to the bone and soft tissue. Periocol® is a resorbable Guided Tissue Regenerative (GTR) membrane that delays the apical migration of gingival epithelium by excluding the gingival connective tissue and allows granulation tissue derived from PDL and osseous tissues to repopulate the space adjacent to the denuded root surface. Objective: To compare DFDBA with Periocol® and Perioglas® with Periocol® membrane in the treatment of intrabony defects clinically and radiographically.Methodology: A patient with bilateral intrabony defects was selected. In one site - Open Flap Debridement (OFD) with Perioglas® and Periocol® membrane was placed and on the other site – OFD with DFDBA and Periocol® membrane was placed.Conclusion: DFDBA with Periocol® membrane has shown better results than Perioglas® with Periocol® membrane.

Periosteum eversion technique – A preliminary technique for root coverage: A case series

The periosteum that covers the bone is highly composed of cellular connective tissue which is rich in vascularity with greater regenerative potential, thereby making it suitable to use as an autogenous graft material. This technique of periosteal eversion uses periosteum to cover the denuded root surface of multiple teeth prior to orthodontic treatment. Therefore, the purpose of the case series was to assess the amount of root coverage obtained with the help of eversion of periosteum where a single surgical site is involved in cases of periodontally compromised teeth that needs orthodontic correction. Patients with Miller's Class II/III were selected with malpositioned teeth. Partial thickness flap was elevated, and the periosteum was separated from the underlying bone surface. It is then everted to cover the exposed root surface and stabilized with vicryl suture. After 6 months of evaluation, periosteal eversion technique covered 75% of the denuded root surface. Hence, the periosteal eversion technique can be used as a preliminary procedure for the treatment of gingival recession that gives support for the tooth for further orthodontic treatment.

Lateral pedicle graft: A treatment modality for root coverage of localized gingival recession: A case report

Gingival recession has been defined as the apical shift of gingival margin from its physiologic level (1 to 2 mm coronal to cementoenamel junction) causing pathologic exposure of root surfaces. Mucogingival esthetic surgery is all about treatment of mucogingival esthetic alterations. Mucogingival problems may be caused by gingival recession often in association with non-carious cervical lesion or by root caries or by altered passive eruption. Patient with gingival recession frequently report to dental clinics which could lead to pain or hypersensitivity, esthetic problem, retention of plaque hence inflamed gingiva, root caries, abrasion and fear of tooth loss. Gingival recession can be treated by surgical or non-surgical means. Nonsurgical means include - restorations, crowns, veneers and gingival masks whereas surgical approaches includes various methods of increasing the width of keratinized tissue such as frenectomy in case of high frenal attachment & root coverage procedures. The lateral displaced pedicle flap was first described by Grupe and Warren in 1956. It was used to cover the isolated, denuded root surfaces that have adequate amount of donor tissue adjacent to the recipient site. The vestibular depth must be adequate to laterally slide the pedicle. A case of gingival recession is presented that was managed using LPG technique. This technique was selected because of certain advantages – single surgical area, preservation of blood supply of flap, the postoperative color being in harmony with surrounding tissue. Keywords: Lateral pedicle, Graft, Gingival recession.

Bernotti V-Y plasty techniq ue for root coverage procedure

Gingival recession is the exposure of the root surface resulting from migration of the gingival margin apical to the cementoenamel junction (CEJ). It may be localized or generalized and can be associated with one or more tooth surfaces. Even though gingival recession may occur without any symptoms it can give rise to pain from exposed dentin, patient concern about loss of the tooth, poor esthetics or root caries. The denuded root surfaces cause deterioration in the esthetic appearance, dentin hypersensitivity, and inability to perform proper oral hygiene procedures. The Bernotti V-Y flap is a coronally advanced flap technique with a “V-Y’’ flap design, which consist of a microsurgery technique with or without connective tissue graft, that will improve mucosal biotype and keratinized band in a predictable way for isolated mucosal recession, dehiscence and translucent tissue at teeth or implant sites. It is a conservative flap design, inspired by Semilunar and Modified Semilunar Tarnow’s technique, to minimize interproximal crestal bone loss and possible loss of papillae around teeth or implants, marginal mucosal position is stabilized avoiding adverse aesthetic outcomes. Miller’s Class I and II recession defects with a minimum height of (two) 2 mm are suitable to be selected to perform the Bernotti V-Y flap. The Bernotti V-Y flap consist of a pedicle flap, making a ¨V ¨incision apically to the recession defect and the flap is coronally advanced. Stability and aesthetic outcomes are achieved with the Bernotti V-Y flap.

Effects of Er:YAG Laser on the Attachment of Human Periodontal Ligament Fibroblasts to Denuded Root Surfaces Simulating Delayed Replantation Cases: An In Vitro Study.

Objective: To investigate the effects of Er:YAG laser on the attachment of human periodontal ligament fibroblasts (hPDLFs) to denuded root surfaces simulating delayed replantation cases. Background data: Dental avulsion is one of the most severe dental traumas, which is often treated with replantation. In delayed replantation scenarios, poor prognosis, including root resorption, usually occurs due to poor root surface conditioning and nonviable hPDLF attachment. Methods: Thirty-six root fragments (5 × 5 × 2 mm) were obtained from periodontium tissue-free premolar root surfaces. Specimens were randomly and equally assigned to the following: Group A, untreated control; Group B, 25 J/cm2 and 10 Hz of Er:YAG laser irradiation; and Group C, 50 J/cm2 and 10 Hz of Er:YAG laser irradiation. Some specimens in each group were then prepared for surface topography visualization under SEM, others were subjected to coculture with hPDLF suspension, and cell adhesion was further evaluated by SEM. Results: Group A presented homogenous smooth root surface, with fewer and round-shaped cells attached; Group B and C exhibited rather rough and irregular morphologies, and spindle-shaped fibroblasts were firmly attached by numerous lamellipodia and extensions. After a 3-day coculture, the number of fibroblasts attached in Group A was significantly lower compared with the other two laser-treated groups (p = 0.008 < 0.05). No significant alterations were observed between the two laser groups (p = 0.135 > 0.05). Conclusions: Er:YAG laser-treated root surfaces are compatible for the attachment of PDLFs, which suggests that Er:YAG laser irradiation may be used as a promising strategy for root surface conditioning in delayed replantation cases.

A Manual Bristleless Toothbrush Demonstrates Slight Improvement in Gingival Recession Compared to a Conventional Soft Manual Brush.

This randomized clinical trial tested whether a novel bristleless toothbrush design is more effective in preventing gingival recession in adults receiving periodontal maintenance than is a soft toothbrush with nylon bristles. Twenty-three subjects with gingival recession were recruited who received regular periodontal maintenance care at Western University of Health Sciences Dental Center, and who did not exhibit signs of acute dental or systemic disease, occlusal discrepancies or parafunctional habits. These subjects were randomly assigned to to two groups, one using a soft nylon-bristled toothbrush, and the other using the experimental toothbrush that contains a brush head with short, soft, rubbery cones. Both groups received regular periodontal maintenance and periodontal exams by blinded examiners every 3-4 months, measuring probing depth, bleeding on probing, and plaque indices. Gingival recession was assessed clinically and through use of a stent on diagnostic casts obtained at each visit. Average probing depths, plaque levels, and the number of sites with bleeding on probing did not change over at least 9 months. After 9 months, there was a small but statistically significant improvement in gingival recession (0.4 mm, p < 0.01) at sites with gingival recession in the experimental toothbrush group compared to the control group. In periodontal maintenance patients, the bristleless toothbrush used in this study was as effective in plaque removal and prevention of gingival inflammation than a conventional toothbrush with soft nylon bristles, while increasing the possibility of gingival tissue rebound over denuded root surfaces.

Platelet Rich Fibrin for the Treatment of Cleft like Gingival Recession: A Case Report

Background: Gingival recession exposes the tooth’s root with aesthetic disfigurement, frequently brings a patient to a dentist’s office for the objectionable aesthetics caused by the disease. This case report addressed the management of localized cleft like gingival recession in the tooth no 31 with the aid of Platelet Rich Fibrin (PRF).&#x0D; Methods: Mucosal flap was retracted from tooth no 41 to 33 followed by curettage and root planning on the effected tooth (where there was gingival recession). Allogenic bone graft was applied over the affected area, covered with freshly prepared autogenous PRF membrane, flap was repositioned and sutured.&#x0D; Results: Within six month after surgery previously denuded root surface of the treated incisor became entirely covered with mucosa and good aesthetics was regained; which after 4 years, maintained stable gingival contour and aesthetics.&#x0D; Conclusion: The result in the presented case indicate that PRF can be applied when cleft like gingival recession due to malocclusion is necessarily to be treated uneventfully with good aesthetics.&#x0D; Bangladesh Med Res Counc Bull 2018; 44: 168-170

Caries protective effect of two Self-etch dentin bonding agents on denuded root dentin surface: In Vitro Study

Objective: To evaluate the caries protective effect of two self-etching dental adhesive agents on the denuded root surface. Materials and methods: The roots of 30 freshly extracted , non-carious human premolars were cleaned and denuded of cementum. The teeth surfaces were covered with acid-resistant nail varnish, exposing two rectangular windows (lingual and buccal surface) of 4 x 4 mm each. The window on the lingual furface served as the control , while the buccal window were treated with dentin bonding agent. All specimens were store in acidifed gel for 6 days for demineralization. The specimens were then divided among two experimental groups-Group A: Optibond all in one and Group B: Bond-1SF.In Group C (control group) bonding agent was not applied. The specimens were stored in 0.9% sodium chloride solution for 14 days. Plano parallel tooth sections (80 ± 20 μm) were obtained. Tooth sections were evaluated for caries‑like demineralized zone under a polarized microscope. The values obtained were analyzed using one‑way ANOVA and Tukey honesty tests. Results: In the Control group the mean depth of demineralization was 80.08µm .The depth of demineralization was significantly reduced in Group A and B. Conclusion: Self-etching dental adhesive agents with and without solvent is an effective method to prevent demineralization of root dentin.

Comparative evaluation of multiple recession coverage procedures with mucogingival area as a prognostic factor: A randomized controlled clinical trial

Background: Denuded root surface may give rise to dentin hypersensitivity, deterioration in the esthetic appearance, and inability to perform proper oral hygiene procedure. Hence, various surgical procedures have been proposed to overcome the problem of gingival recession. Hence, the aim of the study was to perform recession coverage procedures and thereafter to compare the height, width, and thickness of the interdental papilla postoperatively.Materials and Methods: Thirty patients were selected with Miller's Class I/Class II localized gingival recession in the maxillary or mandibular anterior region (age 20–50 years) with the presence of buccal gingival recession (≥2 mm). The baseline measurements of height, width, and thickness of the interdental papilla were measured with a standardized vernier caliper, and width of keratinized gingiva, probing pocket depth, and clinical attachment level were measured with a UNC 15 probe. Mucogingival surgical procedures were performed and evaluated postoperatively up to 6 months.Results: The amount of root coverage was significantly correlated with the interdental papilla.Conclusion: This study indicates that the various recession coverage procedures did not affect the papilla dimension however, recession coverage was seen with lower height of the interdental papilla.

The effectiveness of home-use photobiomodulation toothbrush for treating dentin hypersensitivity: A pilot study.

Dentin hypersensitivity is a frequent oral condition among patients suffering from gingival recession. Recent studies have suggested that photobiomodulation has the potential to reduce inflammation and relieve pain. The present study aims to assess the effectiveness of a new design of photobiomodulation toothbrush with specific irradiation parameters as a homecare device in treating dentin hypersensitivity and to compare its therapeutic effect with that of fluoride varnish. Thirty patients with gingival recession and dentin hypersensitivity were selected and randomly assigned to three groups of equal size: fluoride varnish, photobiomodulation, and the combination. Dentin pain and hypersensitivity were measured using visual analog scale (VAS) by two distinct tests: the contact test with a periodontal probe and the air blast test on the areas of gingival recession and denuded root; once at baseline and again one month after the initial application of treatments. Laser irradiation was carried out at the wavelength of 660 nm in CW with an output power of 40 mW for 30 seconds per spot (1.2 J per spot, 6 J/cm2 energy density, and 200 mW/cm2 power density), perpendicularly to denuded root surfaces in non-contact mode. A significant reduction in dentin pain and hypersensitivity was observed in all three groups. However, the reduction was significantly greater in the combination group. At-home treatment of dentin hypersensitivity with photobiomodulation toothbrush is a convenient, safe, and effective method for the management of dentin hypersensitivity.

The effect of enamel matrix derivatives on root coverage: a 12-month follow-up of a randomized clinical trial.

Subepithelial connective tissue grafts (SCTGs) with a coronally advanced flap (CAF) are accepted as the gold standard for covering denuded root surfaces. In recent years, enamel matrix derivatives (EMDs) have been used for their regenerative potential in periodontics. The aim of this split-mouth and randomized controlled study was to assess the clinical and aesthetical impacts of EMD application in combination with SCTG+CAF in patients with Miller's Class I and II gingival recessions in contralateral canines of the maxilla. Participants who underwent SCTG+CAF+EMD application were identified as the test group (n = 19) and those who underwent SCTG+CAF as control group (n = 19). The outcome parameters were recession depth/width, root coverage percentage, and root coverage aesthetic score (RES). RES was evaluated by two calibrated blind periodontists one year after the treatment. Statistically significant root coverage percentage was observed at one year post-treatment for both groups (p < 0.05). However, significant differences between the groups were not observed in terms of total RES and complete root coverage rate (p > 0.05). The test group had significantly better results than the control according to the soft tissue texture and mucogingival junction alignment results (p < 0.05). These results indicate that EMDs contribute to the healing of soft tissue without scarring. As a result of better wound healing, the EMD-added group exhibited better results in terms of the harmony of the mucogingival junction between adjacent teeth. This paper is the first split-mouth study in which SCTG+CAF and SCTG+CAF+EMD were compared using RES in bilateral canines.