Root coverage of multiple gingival recessions treated with coronally advanced flap associated with xenogeneic acellular dermal matrix or connective tissue graft: a 6-month split-mouth controlled and randomized clinical trial

Objectives This study aimed to compare xenogeneic dermal matrix (XDM) to connective tissue graft (CTG) associated with coronally advanced flap (CAF) in treating Miller's class I and II (RT1) multiple gingival recession in a split-mouth randomized clinical trial. Materials and methods Fifteen patients with bilateral Miller's class I and II multiple recessions were selected. The patient's side receiving each treatment was randomly allocated to receive XDM or CTG. The clinical parameters were measured at baseline and 6 months of follow-up. Results At 6 months, no significant difference in the root coverage (RC) (95.28 +/- 6.89% for CTG and 92.68 +/- 7.35% for XDM) and the keratinized tissue (KT) gain (0.91 +/- 0.46 mm for CTG and 0.74 +/- 0.39 mm for XDM) was observed between groups (p > 0.05). The CTG group presented higher complete root coverage (CRC) than XDM (60% and 33%, respectively) (p = 0.045). Multiple logistic regression indicated that the XDM (p = 0.01) and the XDM and KT interaction (p = 0.02) negatively interfered in the CRC. A 1-mm increase in the baseline KT when using XDM increases almost 6 times the chance of achieving CRC, and XDM reached a similar CRC probability to CTG when the receptor area presented at least 2 mm of KT. Conclusions Both treatments were effective for treating multiple gingival recession; similar KT gain, GR reduction, and RC were obtained for CTG and XDM, while CTG promoted higher CRC than XDM. Moreover, the amount of KT at baseline was determinant for CRC when treating multiple gingival recession with XDM. Trial registration Brazilian Clinical Trials Registry (REBEC) number RBR-56NZQ6

Automated summary

This study compared xenogeneic dermal matrix (XDM) with connective tissue graft (CTG) in treating multiple gingival recession, finding similar outcomes in keratinized tissue gain, gingival recession reduction, and root coverage for both treatments, but CTG showed better promotion of complete root coverage. Additionally, the baseline amount of keratinized tissue was crucial in determining the success of complete root coverage when using XDM for multiple gingival recession treatment.