Porcine Acellular Dermal Matrix Versus Connective Tissue Graft for the Treatment of Multiple Combined Defects: Partial Results

Objectives: Multiple gingival recessions (MGR) are a common clinical finding and are frequently associated with noncarious cervical lesion (NCCL), forming multiple combined defects (MCDs). This condition has a different prognosis when compared with a gingival recession without dental wear associated and often requires a restorative and surgical approach to achieve better esthetic and functional outcomes. Although the multiple combined defects are common finding, there is a lack of evidence about its treatment and the ideal clinical protocol has not been determined. Systematic reviews show that the use of subepithelial connective tissue graft for the treatment of MGR provides more effective and long-term clinical outcomes than others approaches. However, its use is usually associated with a limited amount of donor tissue and higher degree of pain and postoperative discomfort. Thus, the purpose of study was evaluate the use of a new collagen matrix (Mucoderm®) as an alternative to autologous graft for the treatment of RT1 MGR associated with B+ NCCL.
Methods: For this purpose, twenty-two patients presenting multiple RT1 gingival recession associated with B+ noncarious cervical lesion were randomly allocated to the Control Group (n=11), PR + MCAF + CTG, or Test Group (n=11), PR + CAF + XDM. Both the test and control groups received partial restoration (PR) of the NCCL, in which the apical border of the restoration was placed 1 mm beyond the cement-enamel junction estimation, and surgery for root coverage by means modified coronally advanced flap.
Results: After 3 months of follow-up, CD coverage rates were 79,15% (2,81±1,2 mm) for the control group and 68,7% (2,35±1,5 mm) for the test group (p> 0,05).
Conclusions: Therefore, both treatments were effective and resulted in a significant combined defect reduction. However, within the limitations of these study, randomized clinical trials and long-term studies are necessary to evaluate the performance of this new collagen matrix.