Micro-needling versus acellular dermal matrix in RT1 gingival recession coverage: A randomized clinical trial

Area of Science:

• Periodontology
• Regenerative Dentistry
• Oral Plastic Surgery

Background:

• Gingival recession defects, particularly RT1 type in thin gingival phenotypes, present aesthetic challenges.
• Gingival thickness and keratinized tissue width are crucial for periodontal health and aesthetic outcomes.
• Traditional treatments often involve grafting procedures, which can have associated morbidity.

Purpose of the Study:

• To compare the efficacy of coronally advanced flap (CAF) with micro-needling (MN) versus CAF with acellular dermal matrix (ADM) for treating RT1 gingival recession.
• To evaluate the primary outcome of gingival thickness (GT) and secondary outcomes including keratinized tissue width (KTW), clinical attachment level (CAL), and root coverage.
• To assess these outcomes in patients with a thin gingival phenotype over a 6-month period.

Main Methods:

• A randomized controlled trial involving 24 patients with single RT1 gingival recession and thin gingival phenotype.
• Patients were allocated to either CAF + MN (test group, n=12) or CAF + ADM (control group, n=12).
• Clinical parameters including GT, KTW, CAL, probing depth (PD), recession depth (RD), recession width (RW), recession reduction (Rec-Red), complete root coverage (CRC), and percentage of root coverage were measured at baseline, 3, and 6 months.

Main Results:

• Both treatment groups showed significant improvements in GT, KTW, CAL, PD, RD, Rec-Red, CRC, and root coverage percentage (p < .05) at 3 and 6 months.
• No significant intergroup differences were observed for most parameters.
• The CAF + MN group demonstrated a significantly higher gain in KTW at 6 months compared to the CAF + ADM group (5.08 ± 0.9 mm vs. 4.25 ± 1.06 mm; p < .05). Baseline GT was the only significant predictor for 6-month GT.

Conclusions:

• Coronally advanced flap (CAF) followed by micro-needling (MN) is a promising graft-less approach for increasing gingival thickness in RT1 recession defects.
• This technique is comparable to CAF with acellular dermal matrix (ADM) in terms of overall efficacy for root coverage and other periodontal parameters.
• CAF + MN offers a superior improvement in keratinized tissue width compared to CAF + ADM in patients with thin gingival phenotypes, making it a valuable alternative treatment option.