Root coverage using a microsurfaced acellular dermal matrix: A retrospective case series.

Abstract

Background: Acellular dermal matrices (ADMs) have been used for root coverage for over 25 years, yet few advancements have improved clinical outcomes or reduced complications. This case series evaluated the use of a novel microsurfaced ADM (mADM), which features a microtextured surface designed intended to promote healing and improve graft integration, for treating gingival recession defects.

Methods: Eleven RT1 gingival recession defects from five patients were treated using mADM between January and May 2023 by a single surgeon (S.R.). A modified vestibular incision subperiosteal tunnel access technique was used for multiple recession defects, while a subperiosteal pouch technique was performed for single-tooth recession defects. Clinical outcomes were assessed at baseline and 12 months. Pair t-tests were utilized to compare changes overtime.

Results: The mean recession depth reduced from 3.64 ± 0.50 mm to 0.73 ± 0.79 mm after 12 months. Keratinized tissue width increased from 2.32 ± 0.81 mm to 3.36 ± 0.92 mm. Gingival phenotype remained thick for all the cases. Significant root coverage was achieved (p < 0.05) with no graft exposure; complete root coverage was observed in 45.5% (5/11). Patients reported minimal discomfort and satisfactory healing.

Conclusions: Within the limits of this retrospective case series, mADM may be considered a viable option for the treatment of RT1 gingival recession defects. Future randomized clinical trials should be performed to compare this matrix with other options to deal with recession defects.

Key points: In this case study, the novel microsurfaced acellular dermal matrices (mADM) demonstrated significant root coverage improvements in RT1 gingival recession defects, with a mean recession reduction from 3.64 to 0.73 mm at 12 months, achieving 80% root coverage and complete coverage in 45.5% of treated sites. The mADM may serve as a promising alternative to autogenous grafts, but larger-scale randomized clinical trials are necessary to confirm long-term efficacy and patient-reported outcomes.

Plain language summary: For decades, gum recession-when the gum tissue pulls back from the teeth and exposes the roots-has been treated with acellular dermal matrices (ADMs) made from donated cadaver tissue, avoiding the need to harvest tissue from the patient. Although traditional ADM is widely used, concerns exist regarding its healing and long-term stability. In this case series, a new type of ADM called microsurfaced ADM (mADM) was used. Like ADM, mADM is derived from cadaver tissue but has a specially textured surface intended to support graft integration with the gums. Five non-smoking patients were treated with mADM and followed for 12 months. The treatment resulted in excellent root coverage without complications such as graft exposure or infection. Patients reported very little discomfort and were satisfied with the esthetic outcome. Within the limits of this study, these findings indicate that mADM may offer a viable alternative for treating RT1 gum recession defects. Nonetheless, further randomized clinical trials are needed to compare its initial healing, long-term outcomes, and patient-reported outcomes with other treatment options.