Acellular dermal matrix allograft versus subepithelial connective tissue graft in treatment of gingival recessions: a 5-year randomized clinical study

Aim: The present randomized clinical trial compared the long-term results of subepithelial connective tissue graft (SCTG) versus acellular dermal matrix allograft (ADMA) in treatment of gingival recessions. Materials and Methods: In 16 patients with bilateral Miller Class I/II gingival recessions, one side was treated with SCTG and the other side with ADMA. Clinical parameters were measured at baseline, 6 months, and at 5 years post-surgery. Results: Fifteen patients completed the study. At 6 months, all parameters showed significant improvement in ADMA and SCTG groups [complete root coverage (CRC): 73.3% versus 26.7%, p = 0.027; reduction of recession depth (RD): 2.6 +/- 1.1 mm versus 2.2 +/- 1.1 mm, p = 0.376; reduction of recession width (RW): 3.0 +/- 1.4 mm versus 2.4 +/- 1.4 mm, p = 0.207 respectively]. At 5 years, significant relapses were detected in CRC and reduction of RD and RW in both groups with no statistically significant difference (CRC: 20.0% versus 13.3%, p = 1.00; RD: 1.6 +/- 1.2 mm versus 1.5 +/- 1.4mm, p = 0.838; RW: 1.8 +/- 1.4 mm versus 1.3 +/- 1.5mm, p = 0.367). Patients practicing horizontal toothbrushing habit showed more relapse (OR = 11.2; p = 0.01). Compared with baseline, the gingival width (GW) did not increase in ADMA-treated sites (p = 0.903). Conclusion: Five-year results of SCTG and ADMA were similar in terms of CRC and reduction of RD and RW. Both techniques showed a significant relapse associated with returning to horizontal toothbrushing habit. Increase of GW was stable in SCTG-treated sites, but reached to pre-surgical values in ADMA-treated cases.