Connective Tissue Graft and Enamel Matrix Derivative for Periodontal Recession

Objectives: To compare the effectiveness and stability of subepithelial connective tissue graft (SCTG) with and without enamel matrix derivative (EMD) in the treatment of Class I-II Miller periodontal recession defects.
Methods: This randomized clinical study was performed over 2 years. 120 teeth divided into two groups: Group 1 (SCTG with EMD - 68 teeth) and Group 2 (SCTG only - 52 teeth) were assessed. Clinical parameters such as Recession values (REC), Keratinized Tissue (KT), Attachment Loss (AL) and Probing Depth (PD) were measured at baseline, 3 and 24 months.
Results: Both treatments showed significant root coverage after 2 years. The mean periodontal recession decreased from 4.5 mm to 0.41 mm for Group 1 (91%) and 4.2 mm to 0.29 mm in Group 2 (93%). No statistically significant difference between the treatment options was observed. The mean attachment loss reduced from 5.95 mm to 1.55 mm for Group 1 and 5.55 mm to 1.35 mm in Group 2. This was not statistically significant. The mean KT increased from 1.5 mm to 2.5 mm in Group 1 and 1.6 mm to 1.9 mm in Group 2. This increase was statistically significantly (p< 0.01) higher in the EMD treated group.
Conclusions: SCTG provides predictable results in achieving root coverage in Class I-II Miller periodontal recessions. The addition of EMD seems to provide significantly higher amounts of new keratinized tissue.