Root Coverage Using Emdogain Versus Coronally Advanced Flap Technique

Objectives: The aim of this study was to evaluate a comparison of coronally repositioned flap procedure with or without the use of enamel matrix proteins in the treatment of recession defects. Methods: This 2-year study was conducted as a blinded, split-mouth, placebo-controlled and randomised design. It was performed in two dental schools. 30 patients, aged 22-62 years, with 2 paired buccal recession defects of at least 3 mm participated. Surgical recession coverage was performed as coronally advanced flap technique at both sites in the same session. One site was additionally treated with Emdogain (EMD) and the other site with placebo (propylene glycol alginate). A blinded examiner assessed pre- and post-surgical measurements. Clinical measurements and photographs were taken pre-surgically and after 1 week, 3 weeks and 3, 6, 12, 24 months postoperatively. Measurements comprised height and width of the gingival recession, height of keratinized tissue, probing attachment level, probing pocket depth and alveolar bone level. Results: Twenty-four months after therapy, both treatment modalities showed significant root coverage and probing attachment gain. Mean gingival recession decreased from 3.66 mm to 0.89 mm for the EMD treated sites and from 3.88 mm to 1.49 mm for the control sites. However, this difference was not statistically significant (P=0.122). Similarly, all other clinical parameters did not differ significantly in the between-group comparison, except for recession width (P=0.027) and probing pocket depth (P=0.046) exhibiting a higher reduction in the EMD group. Full root coverage could be maintained over 2 years in 53% of the EMD versus merely 23% in the control group. 47% of the recessions in the control group deteriorated again in the second year after therapy compared to 22% in the EMD group. Conclusions: EMD seems to provide better long-term results.

Acknowledgements: The authors want to thank BIORA AB company for supporting the study.