Healing of buccal gingival recessions following treatment with coronally advanced flap alone or combined with a cross-linked hyaluronic acid gel. An experimental study in dogs

Aim To clinically and histologically evaluate in dogs the healing of gingival recessions treated with coronally advanced flap (CAF) with or without cross-linked hyaluronic acid (HA). Materials and methods Gingival recession defects were surgically created on the vestibular side of both maxillary canines in 8 dogs. After 8 weeks of plaque accumulation, the 16 chronic defects were randomly treated with either CAF alone or CAF and HA-gel (CAF/HA). Clinical and histological outcomes were evaluated at 10 weeks post-surgically. Results Compared to baseline, the clinical measurements at 10 weeks revealed a statistically significant decrease in gingival recession for both CAF (p < 0.01) and CAF/HA (p < 0.001) groups. Statistically significant differences were found in clinical attachment level (p < 0.05) and width of gingival recession (p < 0.01) favouring the CAF/HA group. Bone formation was statistically significantly greater in the CAF/HA group than in the CAF group (1.84 +/- 1.16 mm vs., 0.72 +/- 0.62 mm, respectively, p < 0.05). Formation of cementum and connective tissue attachment were statistically significantly higher in the CAF/HA group compared with the CAF group (i.e. 4.31 +/- 1.78 mm versus 2.40 +/- 1.35 mm and 1.69 +/- 0.98 mm versus 0.74 +/- 0.68 mm, respectively (p < 0.05)). Conclusions The present data have for the first time provided histologic evidence for periodontal regeneration of gingival recession defects following treatment with CAF and HA. Clinical relevance The use of HA in conjunction with CAF may represent a novel modality for treating gingival recession defects.

Automated summary

The combination therapy of coronally advanced flap (CAF) with cross-linked hyaluronic acid (HA) shows promising results in promoting gingival recession healing and periodontal regeneration in dogs. Clinical and histological evaluations revealed significant improvements in clinical measurements and tissue formation in the CAF/HA group compared to CAF alone, indicating a potential novel modality for the treatment of gingival recession defects.