Recession coverage using the modified coronally advanced tunnel and connective tissue graft with or without enamel matrix derivative: 5-year results of a randomised clinical trial.
Enamel matrix derivative
Keratinised tissue gain
Modified coronally advanced tunnel
Single and multiple adjacent gingival recessions
Journal
Clinical oral investigations
ISSN: 1436-3771
Titre abrégé: Clin Oral Investig
Pays: Germany
ID NLM: 9707115
Informations de publication
Date de publication:
Jan 2023
Jan 2023
Historique:
received:
18
04
2022
accepted:
15
08
2022
pubmed:
25
8
2022
medline:
28
1
2023
entrez:
24
8
2022
Statut:
ppublish
Résumé
To evaluate the 5-year results of single and multiple recession type (RT) 1 and 2 (Miller I to III) recessions treated with the modified coronally advanced tunnel (MCAT) and connective tissue graft (CTG) with or without an enamel matrix derivative (EMD). The main outcome variable was the stability of obtained root coverage from 6 months to 5 years. In 24 patients, both complete and mean root coverage (CRC and MRC) and gain of keratinised tissue (KT) were assessed at 6 months and 5 years after recession coverage by means of MCAT and CTG with or without EMD. Aesthetic outcomes after 5 years were evaluated using the root coverage aesthetic score (RES). At 5 years, 24 patients with a total of 43 recessions were evaluated. Eight patients (57.14%) of the test and 6 (60.0%) of the control group showed complete root coverage. MRC revealed no statistically significant differences between the two groups, with 73.87 ± 26.83% (test) and 75.04 ± 22.06% (control), respectively. KT increased from 1.14 ± 0.57 mm to 3.07 ± 2.27 mm in the test group and from 1.24 ± 0.92 mm to 3.02 ± 1.55 mm in the control group, respectively. Treatment of single and multiple RT 1 and 2 recessions by means of MCAT and CTG with or without EMD yielded comparable clinical improvements which could be maintained over a period of 5 years. The additional use of EMD did not influence the clinical outcomes. The use of MCAT + CTG yielded successful coverage of single and multiple RT 1 and 2 gingival recessions, while the additional application of EMD did not seem to influence the results.
Identifiants
pubmed: 36002594
doi: 10.1007/s00784-022-04691-8
pii: 10.1007/s00784-022-04691-8
pmc: PMC9402279
doi:
Substances chimiques
enamel matrix proteins
0
Dental Enamel Proteins
0
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Pagination
105-113Informations de copyright
© 2022. The Author(s).
Références
Romandini M, Soldini MC, Montero E, Sanz M (2020) Epidemiology of mid-buccal gingival recessions in NHANES according to the 2018 World Workshop Classification System. J Clin Periodontol 47:1180–1190. https://doi.org/10.1111/jcpe.13353
doi: 10.1111/jcpe.13353
Castellanos A, de la Rosa M, de la Garza M, Caffesse RG (2006) Enamel matrix derivative and coronal flaps to cover marginal tissue recessions. J Periodontol 77:7–14. https://doi.org/10.1902/jop.2006.77.1.7
doi: 10.1902/jop.2006.77.1.7
Chambrone L, Tatakis DN (2016) Long-term outcomes of untreated buccal gingival recessions: a systematic review and meta-analysis. J Periodontol 87:796–808. https://doi.org/10.1902/jop.2016.150625
doi: 10.1902/jop.2016.150625
Cairo F, Nieri M, Pagliaro U (2014) Efficacy of periodontal plastic surgery procedures in the treatment of localized facial gingival recessions A systematic review. J Clin Periodontol 41(Suppl 15):S44-62. https://doi.org/10.1111/jcpe.12182
doi: 10.1111/jcpe.12182
Graziani F, Gennai S, Roldan S, Discepoli N, Buti J, Madianos P, Herrera D (2014) Efficacy of periodontal plastic procedures in the treatment of multiple gingival recessions. J Clin Periodontol 41(Suppl 15):S63-76. https://doi.org/10.1111/jcpe.12172
doi: 10.1111/jcpe.12172
Tavelli L, Barootchi S, Nguyen TVN, Tattan M, Ravida A, Wang HL (2018) Efficacy of tunnel technique in the treatment of localized and multiple gingival recessions: a systematic review and meta-analysis. J Periodontol 89:1075–1090. https://doi.org/10.1002/JPER.18-0066
doi: 10.1002/JPER.18-0066
Miron RJ, Moraschini V, Del Fabbro M, Piattelli A, Fujioka-Kobayashi M, Zhang Y, Saulacic N, Schaller B, Kawase T, Cosgarea R et al (2020) Use of platelet-rich fibrin for the treatment of gingival recessions: a systematic review and meta-analysis. Clin Oral Investig 24:2543–2557. https://doi.org/10.1007/s00784-020-03400-7
doi: 10.1007/s00784-020-03400-7
Sculean A, Allen EP, Katsaros C, Stahli A, Miron RJ, Deppe H, Cosgarea R (2021) The combined laterally closed, coronally advanced tunnel for the treatment of mandibular multiple adjacent gingival recessions: surgical technique and a report of 11 cases. Quintessence Int 52:576–582. https://doi.org/10.3290/j.qi.b1098307
doi: 10.3290/j.qi.b1098307
Sculean A, Allen EP (2018) The laterally closed tunnel for the treatment of deep isolated mandibular recessions: surgical technique and a report of 24 cases. Int J Periodontics Restor Dent 38:479–487. https://doi.org/10.11607/prd.3680
doi: 10.11607/prd.3680
Bertl, K.; Spineli, L.M.; Mohandis, K.; Stavropoulos, A. (2021) Root coverage stability: a systematic overview of controlled clinical trials with at least 5 years of follow-up. Clin Exp Dent Res https://doi.org/10.1002/cre2.395
Chambrone L, de Castro Pinto RCN, Chambrone LA (2019) The concepts of evidence-based periodontal plastic surgery: application of the principles of evidence-based dentistry for the treatment of recession-type defects. Periodontol 2000(79):81–106. https://doi.org/10.1111/prd.12248
doi: 10.1111/prd.12248
McGuire MK, Scheyer ET, Schupbach P (2016) A prospective, case-controlled study evaluating the use of enamel matrix derivative on human buccal recession defects: a human histologic examination. J Periodontol 87:645–653. https://doi.org/10.1902/jop.2016.150459
doi: 10.1902/jop.2016.150459
Shirakata Y, Nakamura T, Shinohara Y, Nakamura-Hasegawa K, Hashiguchi C, Takeuchi N, Imafuji T, Sculean A, Noguchi K (2019) Split-mouth evaluation of connective tissue graft with or without enamel matrix derivative for the treatment of isolated gingival recessions in dogs. Clin Oral Investig 23:3339–3349
doi: 10.1007/s00784-018-2750-1
Mercado F, Hamlet S, Ivanovski S (2020) A 3-year prospective clinical and patient-centered trial on subepithelial connective tissue graft with or without enamel matrix derivative in Class I-II Miller recessions. J Periodontal Res 55:296–306. https://doi.org/10.1111/jre.12715
doi: 10.1111/jre.12715
Hagewald S, Spahr A, Rompola E, Haller B, Heijl L, Bernimoulin JP (2002) Comparative study of Emdogain and coronally advanced flap technique in the treatment of human gingival recessions. A prospective controlled clinical study. J Clin Periodontol 29:35–41
doi: 10.1034/j.1600-051x.2002.290106.x
Cueva MA, Boltchi FE, Hallmon WW, Nunn ME, Rivera-Hidalgo F, Rees T (2004) A comparative study of coronally advanced flaps with and without the addition of enamel matrix derivative in the treatment of marginal tissue recession. J Periodontol 75:949–956. https://doi.org/10.1902/jop.2004.75.7.949
doi: 10.1902/jop.2004.75.7.949
McGuire MK, Nunn M (2003) Evaluation of human recession defects treated with coronally advanced flaps and either enamel matrix derivative or connective tissue. Part 1: comparison of clinical parameters. J Periodontol 74:1110–1125. https://doi.org/10.1902/jop.2003.74.8.1110
doi: 10.1902/jop.2003.74.8.1110
Meza Mauricio J, Furquim CP, Bustillos-Torrez W, Soto-Penaloza D, Penarrocha-Oltra D, Retamal-Valdes B, Faveri M (2021) Does enamel matrix derivative application provide additional clinical benefits in the treatment of maxillary Miller class I and II gingival recession? A systematic review and meta-analysis. Clin Oral Investig 25:1613–1626. https://doi.org/10.1007/s00784-021-03782-2
doi: 10.1007/s00784-021-03782-2
Raetzke PB (1985) Covering localized areas of root exposure employing the “envelope” technique. J Periodontol 56:397–402. https://doi.org/10.1902/jop.1985.56.7.397
doi: 10.1902/jop.1985.56.7.397
Allen AL (1994) Use of the supraperiosteal envelope in soft tissue grafting for root coverage. I. Rationale and technique. Int J Periodontics Restor Dent 14:216–227
Zabalegui I, Sicilia A, Cambra J, Gil J, Sanz M (1999) Treatment of multiple adjacent gingival recessions with the tunnel subepithelial connective tissue graft: a clinical report. Int J Periodontics Restor Dent 19:199–206
Azzi R, Etienne D, Takei H, Fenech P (2002) Surgical thickening of the existing gingiva and reconstruction of interdental papillae around implant-supported restorations. Int J Periodontics Restor Dent 22:71–77
Sculean A, Cosgarea R, Stahli A, Katsaros C, Arweiler NB, Brecx M, Deppe H (2014) The modified coronally advanced tunnel combined with an enamel matrix derivative and subepithelial connective tissue graft for the treatment of isolated mandibular Miller class I and II gingival recessions: a report of 16 cases. Quintessence Int 45:829–835. https://doi.org/10.3290/j.qi.a32636
doi: 10.3290/j.qi.a32636
Salhi L, Lecloux G, Seidel L, Rompen E, Lambert F (2014) Coronally advanced flap versus the pouch technique combined with a connective tissue graft to treat Miller’s class I gingival recession: a randomized controlled trial. J Clin Periodontol 41:387–395. https://doi.org/10.1111/jcpe.12207
doi: 10.1111/jcpe.12207
Aroca S, Molnar B, Windisch P, Gera I, Salvi GE, Nikolidakis D, Sculean A (2013) Treatment of multiple adjacent Miller class I and II gingival recessions with a modified coronally advanced tunnel (MCAT) technique and a collagen matrix or palatal connective tissue graft: a randomized, controlled clinical trial. J Clin Periodontol 40:713–720. https://doi.org/10.1111/jcpe.12112
doi: 10.1111/jcpe.12112
Sculean A, Cosgarea R, Stahli A, Katsaros C, Arweiler NB, Miron RJ, Deppe H (2016) Treatment of multiple adjacent maxillary Miller class I, II, and III gingival recessions with the modified coronally advanced tunnel, enamel matrix derivative, and subepithelial connective tissue graft: a report of 12 cases. Quintessence Int 47:653–659. https://doi.org/10.3290/j.qi.a36562
doi: 10.3290/j.qi.a36562
Aroca S, Keglevich T, Nikolidakis D, Gera I, Nagy K, Azzi R, Etienne D (2010) Treatment of class III multiple gingival recessions: a randomized-clinical trial. J Clin Periodontol 37:88–97. https://doi.org/10.1111/j.1600-051X.2009.01492.x
doi: 10.1111/j.1600-051X.2009.01492.x
Cairo F, Nieri M, Cincinelli S, Mervelt J, Pagliaro U (2011) The interproximal clinical attachment level to classify gingival recessions and predict root coverage outcomes: an explorative and reliability study. J Clin Periodontol 38:661–666. https://doi.org/10.1111/j.1600-051X.2011.01732.x
doi: 10.1111/j.1600-051X.2011.01732.x
Miller PD Jr (1985) A classification of marginal tissue recession. Int J Periodontics Restor Dent 5:8–13
Stähli A, Imber JC, Raptis E, Salvi GE, Eick S, Sculean A (2020) Effect of enamel matrix derivative on wound healing following gingival recession coverage using the modified coronally advanced tunnel and subepithelial connective tissue graft: a randomised, controlled, clinical study. Clin Oral Investig 24:1043–1051. https://doi.org/10.1007/s00784-019-03008-6
doi: 10.1007/s00784-019-03008-6
Cairo F, Rotundo R, Miller PD, Pini Prato GP (2009) Root coverage esthetic score: a system to evaluate the esthetic outcome of the treatment of gingival recession through evaluation of clinical cases. J Periodontol 80:705–710. https://doi.org/10.1902/jop.2009.080565
doi: 10.1902/jop.2009.080565
O’Leary TJ, Drake RB, Naylor JE (1972) The plaque control record. J Periodontol 43:38. https://doi.org/10.1902/jop.1972.43.1.38
doi: 10.1902/jop.1972.43.1.38
Chambrone L, Ortega MAS, Sukekava F, Rotundo R, Kalemaj Z, Buti J, Prato GPP (2019) Root coverage procedures for treating single and multiple recession-type defects: an updated Cochrane systematic review. J Periodontol 90:1399–1422. https://doi.org/10.1002/JPER.19-0079
doi: 10.1002/JPER.19-0079
Azaripour A, Kissinger M, Farina VS, Van Noorden CJ, Gerhold-Ay A, Willershausen B, Cortellini P (2016) Root coverage with connective tissue graft associated with coronally advanced flap or tunnel technique: a randomized, double-blind, mono-centre clinical trial. J Clin Periodontol 43:1142–1150. https://doi.org/10.1111/jcpe.12627
doi: 10.1111/jcpe.12627
Aydinyurt HS, Tekin Y, Ertugrul AS (2019) The effect of enamel matrix derivatives on root coverage: a 12-month follow-up of a randomized clinical trial. Braz Oral Res 33:e006. https://doi.org/10.1590/1807-3107bor-2019.vol33.0006
doi: 10.1590/1807-3107bor-2019.vol33.0006
Gorski B, Gorska R, Wysokinska-Miszczuk J, Kaczynski T (2020) Tunnel technique with enamel matrix derivative in addition to subepithelial connective tissue graft compared with connective tissue graft alone for the treatment of multiple gingival recessions: a randomized clinical trial. Clin Oral Investig 24:4475–4486. https://doi.org/10.1007/s00784-020-03312-6
doi: 10.1007/s00784-020-03312-6
Zuhr, O.; Akakpo, D.; Eickholz, P.; Vach, K.; Hurzeler, M.B.; Petsos, H.; (2021) Research Group for Oral Soft Tissue, B.; Wound, H. Tunnel technique with connective tissue graft versus coronally advanced flap with enamel matrix derivate for root coverage: 5-year results of an RCT using 3D digital measurement technology for volumetric comparison of soft tissue changes. J Clin Periodontol, https://doi.org/10.1111/jcpe.13470 .
Salem, S.; Salhi, L.; Seidel, L.; Lecloux, G.; Rompen, E.; Lambert, F. (2020) Tunnel/pouch versus coronally advanced flap combined with a connective tissue graft for the treatment of maxillary gingival recessions: four-year follow-up of a randomized controlled trial. J Clin Med 9, https://doi.org/10.3390/jcm9082641 .
Barootchi S, Tavelli L, Di Gianfilippo R, Byun HY, Oh TJ, Barbato L, Cairo F, Wang HL (2019) Long term assessment of root coverage stability using connective tissue graft with or without an epithelial collar for gingival recession treatment. A 12-year follow-up from a randomized clinical trial. J Clin Periodontol 46:1124–1133. https://doi.org/10.1111/jcpe.13187
doi: 10.1111/jcpe.13187
Pini Prato GP, Franceschi D, Cortellini P, Chambrone L (2018) Long-term evaluation (20 years) of the outcomes of subepithelial connective tissue graft plus coronally advanced flap in the treatment of maxillary single recession-type defects. J Periodontol 89:1290–1299. https://doi.org/10.1002/JPER.17-0619
doi: 10.1002/JPER.17-0619
Cosgarea R, Miron R, Bora R, Rosu A, Buduru S, Sculean A (2021) Long-term results after treatment of multiple adjacent gingival recessions with the modified coronally advanced tunnel and a porcine acellular dermal matrix. Quintessence Int 52:32–44. https://doi.org/10.3290/j.qi.a45171
doi: 10.3290/j.qi.a45171
Jepsen K, Stefanini M, Sanz M, Zucchelli G, Jepsen S (2017) Long-term stability of root coverage by coronally advanced flap procedures. J Periodontol 88:626–633. https://doi.org/10.1902/jop.2017.160767
doi: 10.1902/jop.2017.160767
Bhatavadekar NB, Gharpure AS, Chambrone L (2019) Long-term outcomes of coronally advanced tunnel flap (CATF) and the envelope flap (mCAF) plus subepithelial connective tissue graft (SCTG) in the treatment of multiple recession-type defects a 6-year retrospective analysis. Int J Periodontics Restor Dent 39:623–630. https://doi.org/10.11607/prd.4026
doi: 10.11607/prd.4026
Petsos H, Eickholz P, Raetzke P, Nickles K, Dannewitz B, Hansmeier U (2020) Clinical and patient-centred long-term results of root coverage using the envelope technique in a private practice setting: 10-year results-a case series. J Clin Periodontol 47:372–381. https://doi.org/10.1111/jcpe.13242
doi: 10.1111/jcpe.13242
Rasperini G, Acunzo R, Pellegrini G, Pagni G, Tonetti M, Pini Prato GP, Cortellini P (2018) Predictor factors for long-term outcomes stability of coronally advanced flap with or without connective tissue graft in the treatment of single maxillary gingival recessions: 9 years results of a randomized controlled clinical trial. J Clin Periodontol 45:1107–1117. https://doi.org/10.1111/jcpe.12932
doi: 10.1111/jcpe.12932
Zucchelli G, De Sanctis M (2005) Long-term outcome following treatment of multiple Miller class I and II recession defects in esthetic areas of the mouth. J Periodontol 76:2286–2292. https://doi.org/10.1902/jop.2005.76.12.2286
doi: 10.1902/jop.2005.76.12.2286
Ainamo A, Bergenholtz A, Hugoson A, Ainamo J (1992) Location of the mucogingival junction 18 years after apically repositioned flap surgery. J Clin Periodontol 19:49–52. https://doi.org/10.1111/j.1600-051x.1992.tb01148.x
doi: 10.1111/j.1600-051x.1992.tb01148.x
Gurgan CA, Oruc AM, Akkaya M (2004) Alterations in location of the mucogingival junction 5 years after coronally repositioned flap surgery. J Periodontol 75:893–901. https://doi.org/10.1902/jop.2004.75.6.893
doi: 10.1902/jop.2004.75.6.893
Gorski, B.; Gorska, R.; Szerszen, M.; Kaczynski, T. (2021) Modified coronally advanced tunnel technique with enamel matrix derivative in addition to subepithelial connective tissue graft compared with connective tissue graft alone for the treatment of multiple gingival recessions: prognostic parameters for clinical treatment outcomes. Clin Oral Investig https://doi.org/10.1007/s00784-021-04045-w