Ten-Year Split-Mouth Follow-Up of Tunnel Technique Using Connective Tissue Graft Versus Acellular Dermal Matrix for...

Long-term split-mouth comparisons between autogenous connective tissue grafts and acellular dermal matrices using the tunnel technique remain limited in the literature. Gingival recession may lead to root exposure, hypersensitivity, and esthetic concerns. Connective tissue grafts are widely considered the gold standard for root coverage; however, palatal harvesting is associated with postoperative morbidity when multiple sites are treated. Acellular dermal matrix has been proposed as a donor-site-free alternative.

A 55-year-old female patient presented with multiple RT1 gingival recessions and dentin hypersensitivity. A split-mouth design was performed. On the right maxilla, a tunnel technique combined with an autogenous connective tissue graft was used, whereas on the left maxilla, the same technique was combined with acellular dermal matrix. Clinical measurements and photographic documentation were obtained up to 10 years.

During the first 2 years, mean root coverage was 100% on the CTG-treated side and 95% on the ADM-treated side. At Year 6, mean root coverage remained 100% on the CTG-treated side and decreased to 67% on the ADM-treated side. Complete root coverage was maintained in 75% and 40% of sites, respectively. Relapse occurred primarily in acellular dermal matrix-treated teeth after Year 6, whereas the soft-tissue phenotype remained clinically stable on both sides. The patient reported high satisfaction and complete resolution of hypersensitivity.

In this single case, the CTG-treated side showed greater observed stability at 10 years, whereas ADM provided satisfactory clinical outcomes with lower donor-site morbidity. These observations are descriptive and should not be interpreted as evidence of comparative effectiveness or generalized beyond this patient.