A Comparative Study of Root Coverage Using Dynamatrix Plus versus Connective Tissue Graft
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The purpose of this randomized clinical study was to compare the root coverage outcomes and clinical attachment levels in areas of facial gingival recession between an autograft and a xenograft. The materials investigated were autogenous connective tissue graft (CTG) and porcine derived extracellular matrix (ECM, DynaMatrix Plus®, Keystone Dental). Twenty-two non-smoking, healthy patients participated in the study based on their existing gingival recession. Patients with qualifying Miller Class I, II, or III gingival recession defects were evaluated and randomly assigned to either CTG (control) or ECM (test) groups. Patients that presented with two similar, bilateral defects had one defect treated with CTG and the other with ECM. Both test and control sites were treated with identical surgical technique with the only difference in treatment being the graft material. Clinical parameters included: root vertical recession (VR), horizontal recession, probing depth (PD), clinical attachment level (CAL), bleeding on probing, keratinized tissue width (KT), and papillary height and width. All patients had measurements taken at baseline, 3 and 6 months after surgery. Two patients dropped out of the study. Thus 20 patients with 28 sites completed the study. Thirteen sites received CTG while 15 sites received ECM. Baseline mean VR (CTG = 2.81±0.663 mm and ECM = 2.73±0.594) and CAL (CTG = 4.27±0.992 mm and ECM = 4.20±0.797 mm) showed no significant difference between groups. At 6 months, mean VR decreased significantly in both groups (CTG = 0.69±0.879 mm and ECM = 0.97±0.694 mm), whereas mean CAL increased significantly in both groups (CTG = 2.00±0.913 mm and ECM = 2.00±0.732 mm). Intergroup differences in mean VR and CAL were non-significant at 6 months. KT was higher in the test group than the control group at 6 months, although the intergroup difference was not statistically significant. The results of 20 Miller Class III defects of the total 28 sites were analyzed separately, and no statistically significant differences were detected in VR and CAL between test and control. Based on the results of this study, VR and CAL improved significantly in both test and control groups from baseline to 6 months post-operatively. There was no significant long term (6 months) difference between test and control groups in VR and CAL.
connective tissue graft
small intestine submucosa
Goodwin, Michael (2015). A Comparative Study of Root Coverage Using Dynamatrix Plus versus Connective Tissue Graft. Master's thesis, Texas A & M University. Available electronically from