Converting Tissue Biotype Using Acellular Dermal Matrix And Allograft

Objectives:  The root coverage is a surgery to cover denuded roots by various techniques. Subepithelium connective tissue autogenous graft procedure is considered as a golden standard of the procedure. However, it’s limited to soft tissue level without bone regeneration. Recently, acellular dermal matrix (ADM) is used as alternative material to achieve similar outcome. The purpose of this case report is to investigate a novel concept to combine ADM, and freeze dried bone allograft (FDBA) to achieve both soft tissue and hard tissue augmentation.

Methods:  Subjects with bilateral Miller class I recession were reviewed. The patient received ADM only for one side and ADM+FDBA for the other side. Intraoral surgical stent was fabricated to measure the following data: 1. vertical gingival recession depth (VRD): the distance from the CEJ to the free gingival margin 2.clinical attachment level (CAL): the distance from the CEJ to the base of the gingival crevice; 3. probing depth (PD):the distance between the free gingival margin and the base of the gingival crevice; and 4. width of keratinized tissue (WKT): the distance from the free gingival margin to the mucogingival junction. 5. Tissue thickness. All the measurement was taken from baseline, 3 months and 6 months post surgery.

Results: There was no significant difference of VRD, CAL, PD, WKT for the patients, but the tissue thickness was significant. The both groups showed a significant gain of CAL in 3 months and 6 months and increased WKT in 6 months compared to the baseline. ADM+FDBA side showed no changes at 6 months compared to ADM only side.

Conclusions: Root coverage with ADM+FDBA has potential benefit for its stability. Further investigation including RCT will be needed to confirm the findings of this clinical cases.