Root coverage technique with enamel matrix derivative

Various periodontal plastic surgical techniques are employed in obtaining root coverage. Recently, the use of an enamel matrix derivative (EMD) has been reported in such treatment. We report 2 cases of root coverage surgery with a coronally positioned flap in combination with EMD (CPF+EMD) and connective tissue graft in combination with EMD (CTG+EMD). Case 1: The patient was a 25-year-old woman referred to Suidobashi Hospital, Tokyo Dental College for root coverage surgery on the lower right first premolar. Gingival recession was classified as Miller Class II, as no alveolar bone loss or loss of attachment was observed in the interdental area, although recession had progressed to the mucogingival junction. The patient was diagnosed with local gingival recession caused by excessive tooth brushing. Primary conservative treatment failed to reduce the gingival recession. Subsequently, root coverage surgery with CPF+EMD was carried out. As observation at the 1-year follow-up revealed complete root coverage and no recurrence of root exposure or subjective symptoms, the postoperative course was considered to be favorable. Case 2: The patient was a 39-year-old woman referred to Suidobashi Hospital, Tokyo Dental College for root coverage surgery on the lower left canine. Gingival recession was classified as Miller Class II. Root coverage surgery with CTG+EMD was carried out. As observation at the 2-month follow-up revealed complete root coverage and no recurrence of root exposure, the postoperative course was considered to be favorable. These 2 cases indicate the effectiveness of root coverage surgery with CPF+EMD and CTG+EMD.