Application of subepithelial connective tissue graft with or without enamel matrix derivative for root coverage: a split-mouth randomized study

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The primary aim of this randomized clinical investigation was to evaluate gingival recession defects treated by a coronally advanced flap and sub-epithelial connective tissue graft (SCTG) with or without enamel matrix derivative (EMD). Twelve patients with Millers class III buccal recession defects of ≥2.0 mm in similar contra lateral sites were included in this split-mouth randomized study. Test sites were treated with SCTG plus EMD while control sites received SCTG only. At baseline, 6 months and 12 months, clinical parameters such as recession level (RL), probing depth (PD), clinical attachment level (CAL), and apico-cervical width of keratinized tissue (KT) were determined. A P value <0.05 was considered significant. Compared to the baseline and based on paired t tests, both groups had significant improvement in all the clinical parameters. However, the test group showed better results in RL (P = 0.046) and CAL (P = 0.023) at 6 months. At 12 months, the test group demonstrated better results in RL (P = 0.01), PD (P = 0.017) and CAL (P = 0.001). Only the KT results were not significantly different between groups at both 6 and 12 months (P = 0.708) and (P = 0.570), respectively. The present study demonstrated the benefit of adding EMD to SCTG for root coverage in Millers class III buccal gingival recession defects after 12 months. (J Oral Sci 52, 463-471, 2010)