A Comparative Study of Root Coverage Using OrACELL™ Versus Subepithelial Connective Tissue Graft
Abstract
Gingival recession is defined as a mucogingival deformity that includes the apical displacement of the marginal soft tissues below the cementoenamel junction, loss of attached gingiva, and exposure of root surfaces. The purpose of this randomized control clinical study was to compare outcomes of root coverage and clinical attachment levels between autograft and allograft in areas of facial gingival recession. Autogenous connective tissue graft (CTG) and decellularized human dermis (OrACELL™, LifeNet Health) were investigated.
Twenty-four non-smoking, healthy patients, with 2mm or greater of facial gingival recession at a minimum of one site that classified as a Miller Class I, II, or III recession defect were included in the study. Patients were randomly assigned to either control (CTG) or OrACELL™ (test) groups. Both test and control sites were treated with identical surgical techniques. The following clinical parameters were evaluated: vertical recession (VR), horizontal recession (HR), probing depth (PD), clinical attachment level (CAL), presence or absence of bleeding on probing (BOP), papillary height and width, and the width of the keratinized tissue (KT). Measurements were made at baseline, 3-, and 6-months.
All 24 patients completed the study, with 23 patients having Miller Class III defects. Eleven sites received CTG while 13 sites received OrACELL™. Baseline mean VR (CTG = 3.27±0.68mm and OrACELL™ = 3.50±0.89mm) and CAL (CTG = 4.86±0.74mm and OrACELL™ = 4.73±0.90mm) showed no significant difference between groups. At 6 months, mean VR (CTG = 0.59±0.70mm and OrACELL™ = 1.19±1.07mm) significantly decreased in both groups, whereas CAL (CTG = 1.90±1.00mm and OrACELL™ = 2.42±1.17mm) significantly increased in both groups. Differences between group means were not statistically significant. There was a noted increase in KT in both the CTG and OrACELL groups, but it was not statistically significantly different at 6 months (CTG = 2.54±1.62mm and OrACELL™ = 2.50±1.58mm) from baseline (CTG = 1.95±1.80mm and OrACELL™ = 2.03±0.95mm).
Based on the results of this study, VR and CAL improved significantly in both the CTG and OrACELL™ groups from baseline to 6 months post-operatively. There were no significant differences between the CTG group or OrACELL™ group in VR or CAL over the course of the study. Miller Class III recession defects responded similarly with both CTG and OrACELL™.
Citation
Vreeburg, Sean Kevin (2017). A Comparative Study of Root Coverage Using OrACELL™ Versus Subepithelial Connective Tissue Graft. Master's thesis, Texas A & M University. Available electronically from https : / /hdl .handle .net /1969 .1 /161356.