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A comparative study of root coverage using acellular dermal matrix with and without enamel matrix derivative.
Sang Ho Shin1, Marco A Cueva, David G Kerns
1Department of Periodontics, Texas A&M University Health Science Center, Baylor College of Dentistry, Dallas, TX 75246, USA.
Journal of Periodontology
|March 6, 2007
Summary
Adding enamel matrix derivative (EMD) to acellular dermal matrix (ADM) significantly increased keratinized tissue for root coverage. However, EMD did not improve root coverage or probing attachment levels compared to ADM alone.
Area of Science:
- Periodontology
- Regenerative Dentistry
- Tissue Engineering
Background:
- Gingival recession affects numerous patients, leading to aesthetic concerns and increased tooth sensitivity.
- Acellular dermal matrix (ADM) is a common graft material used in periodontal plastic surgery to treat gingival recession.
- Enamel matrix derivative (EMD) has shown potential in promoting periodontal regeneration.
Purpose of the Study:
- To compare the efficacy of acellular dermal matrix (ADM) with and without enamel matrix derivative (EMD) for root coverage.
- To evaluate the impact of ADM with and without EMD on the percentage of root coverage, probing attachment level, and keratinized tissue.
- To assess treatment outcomes at 3 and 6 months post-operatively.
Main Methods:
- A split-mouth study design involving 82 contralateral sites in 14 patients with Miller Class I or III buccal recession.
- Test sites received coronally advanced flap (CAF) with ADM and EMD; control sites received CAF with ADM alone.
- Paired t-tests were used for statistical analysis, with patients serving as the unit of analysis.
Main Results:
- Both treatment groups showed significant improvements in root coverage, probing attachment levels, and keratinized tissue.
- The test group (ADM + EMD) demonstrated a statistically significant greater increase in keratinized tissue compared to the control group (ADM alone) at 6 months (P = 0.006).
- No significant differences were observed in the percentage of root coverage or probing attachment level between the two groups.
Conclusions:
- Enamel matrix derivative (EMD) combined with acellular dermal matrix (ADM) significantly enhances keratinized tissue augmentation during root coverage procedures.
- The addition of EMD to ADM did not yield statistically significant improvements in root coverage percentage or probing attachment level.
- ADM alone or with EMD provides significant root coverage and improves probing attachment levels, with EMD offering an added benefit for keratinized tissue gain.