Comparison Between Micro‐ and Macrosurgical Techniques for the Treatment of Localized Gingival Recessions Using Coronally Positioned Flaps and Enamel Matrix Derivative

• Published in: Journal of periodontology (1970) 2010-11, Vol.81 (11), p.1572-1579
• Main Authors: Andrade, Patrícia F., Grisi, Márcio F.M., Marcaccini, Andrea M., Fernandes, Patrícia G., Reino, Danilo M., Souza, Sérgio L.S., Taba, Mário, Palioto, Daniela B., Novaes, Arthur B.
• Format: Article
• Language: English
• Subjects: Absorbable Implants; Adult; Biological and medical sciences; Clinical trial; Dental Enamel Proteins - therapeutic use; Dentistry; enamel matrix proteins; Female; Follow-Up Studies; Gingiva - pathology; gingival recession; Gingival Recession - classification; Gingival Recession - pathology; Gingival Recession - surgery; Guided Tissue Regeneration, Periodontal - methods; Humans; Male; Medical sciences; microsurgery; Microsurgery - instrumentation; Microsurgery - methods; Otorhinolaryngology. Stomatology; Pain, Postoperative - etiology; Periodontal Attachment Loss - surgery; Periodontal Pocket - surgery; Surgical Flaps; Suture Techniques; Sutures; Tooth Root - pathology; Wound Healing - physiology; Young Adult
• ISSN: 0022-3492; 1943-3670
• DOI: 10.1902/jop.2010.100155

Background: The aim of this study is to compare the macro‐ and microsurgery techniques for root coverage using a coronally positioned flap (CPF) associated with enamel matrix derivative (EMD). Methods: Thirty patients were selected for the treatment of localized gingival recessions (GRs) using CPF associated to EMD. Fifteen patients were randomly assigned to the test group (TG), and 15 patients were randomly assigned to the control group (CG). The microsurgical approach was performed in the TG, and the conventional macrosurgical technique was performed in the CG. The clinical parameters evaluated before surgery and after 6 months were GR, probing depth, relative clinical attachment level, width of keratinized tissue (WKT), and thickness of keratinized tissue (TKT). The discomfort evaluation was performed 1 week postoperative. Results: There were no statistically significant differences between groups for all parameters at baseline. At 6 months, there was no statistically significant difference between the techniques in achieving root coverage. The percentage of root coverage was 92% and 83% for TG and CG, respectively. After 6 months, there was a statistically significant increase of WKT and TKT in TG only. Both procedures were well tolerated by all patients. Conclusions: The macro‐ and microsurgery techniques provided a statistically significant reduction in GR height. After 6 months, there was no statistically significant difference between the techniques regarding root coverage, and the microsurgical technique demonstrated a statistically significant increase in WKT and TKT.